Covenant Hospice Inc. agreed to pay $10.1 million to reimburse the government for alleged overbilling of Medicare, Tricare and Medicaid for hospice services, the Department of Justice announced June 18.
Covenant Hospice Inc. is a nonprofit hospice care provider with locations in Fort Walton Beach, Milton and Pensacola, as well as Southern Alabama.
The settlement resolves allegations that between Jan. 1, 2009, and Dec. 31, 2010, Covenant Hospice Inc. improperly submitted hospice claims for general inpatient care that should have been billed at the routine home care level for Medicare, Tricare and Medicaid patients, according to a release from the federal Department of Justice. The government alleged that Covenant Hospice Inc.’s medical records did not support the medical necessity of the general inpatient care.
“Careful and correct claims for reimbursement from critical federal health care programs are essential to the health of our economy,” said U.S. Attorney Pamela C. Marsh of the Northern District of Florida. “Those public servants who worked hard to investigate the conduct and obtain this settlement deserve our deepest gratitude. We will continue our efforts to ensure that federal dollars intended for compassionate care and legitimate patient needs are protected.”
The federal government will recover $9,597,118.44 for Covenant Hospice Inc.’s overbilling to Medicare, Tricare and Medicaid, and Alabama and Florida will collectively recover $552,255.56 as a result of overbilling of their respective Medicaid programs. The Medicaid program is jointly funded by the federal and state governments.