Tennessee to receive payout from hospice settlement, DOJ announces

NASHVILLE, Tenn. (WKRN) — A national hospice care provider has settled federal and state false claims lawsuits, according to the Department of Justice (DOJ).

A Wednesday press release from the DOJ stated that this settlement also resolves allegations made in a 2021 complaint the United States filed in conjunction with the state of Tennessee. The 2021 complaint had been filed against Curo Health Services and related entities. The state of Tennessee will receive $448,800 from the settlement.

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“From 2010 until February 2020, the defendants knowingly submitted or caused to be submitted false claims for hospice services provided to Avalon hospice patients in Tennessee who were ineligible for the Medicare or Medicaid hospice benefit because they were not terminally ill,” the release stated.

This most recent settlement also resolved allegations that defendants improperly concealed or avoided Avalon Hospice’s obligation to repay hospice claims.

The announcement added that Gentiva, the successor to hospice care provider Kindred at Home, has agreed to pay over $19 million to resolve allegations that Kindred at Home and other Kindred entities knowingly kept overpayments from hospice patients.

The affected patients were reportedly unable to receive hospice care benefits under other federal healthcare operations. Additionally, the settlement resolved allegations against SouthernCare and SouthernCare New Beacon hospice facilities that knowingly submitted false service claims. Those facilities were located across the Southeast and the Midwest, but not in Tennessee or Kentucky.

“Hospice provides vital care and support for terminally ill patients and their families. Medicare’s and TennCare’s eligibility requirements ensure that federal and state health care money is properly used to support hospice programs,” said U.S. Attorney Henry C. Leventis for the Middle District of Tennessee. “We are committed to holding accountable health care companies and providers who prioritize profits over patient care by ignoring these requirements.”

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Liability has yet to be determined in this case. The DOJ added that tips or complaints about potential fraud, waste, abuse and mismanagement can be reported to the Department of Heath and Human Services at 1-800-HHS-TIPS (800-447-8477).

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