An Oklahoma hospice provider lied about the amount of services it had provided and made patients appear sicker than they actually were as part of a scheme to defraud Medicare for three years.
Prairie View Hospice in Oklahoma City hid the true conditions of its patients in an attempt to “pass” a Medicare audit and siphon more money from the federal program, the Justice Department said.
The hospice company forged Medicare claims that showed its nurses had visited their terminally ill patients when, in fact, they had not.
To continue receiving Medicare reimbursements for hospice services, Prairie View faked notes from nurses that exaggerated the illnesses of their patients, according to the Justice Department.
Paula Kluding, Prairie View’s owner, also submitted falsified patient files to a Medicare subcontractor tasked with auditing the company.
Prairie View overbilled Medicare through the scheme from July 2010 to July 2013, the Justice Department said.
Kluding was found guilty on 39 counts of fraud-related charges, Justice Department officials said. She faces up to five years in prison and a $250,000 fine on each count.
Healthcare fraud wastes billions of taxpayer dollars every year. With the country’s healthcare expenditures expected to exceed $3 trillion this year, such fraud will continue to spread, according to the FBI.
A 2012 Medicare Payment Advisory Commission report found Medicare spending on hospice care has quadrupled since 2000, with more patients staying under hospice care for longer periods of time. For-profit providers accounted for almost all the growth in hospice care, the report said.
Go here to read the Department of Justice report.
