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ARTICLE ID 195895

$________ – DOJ – IMPROPER CLAIMS – HOSPICE COMPANY ACCUSED OF BILLING MEDICARE, TRICARE AND MEDICAID FOR NON-ESSENTIAL CARE – ALLEGED OVERBILLING.

Escambia County, FL

In this action, the United States, and two states, accused a hospice services company of defrauding state and federal medical insurance programs. The suit was resolved via settlement.

The plaintiffs, the U.S. Department of Justice (DOJ), and the States of Alabama and Florida, alleged that between Jan. 1, ________ and Dec. 31, ________, the defendant, 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. The plaintiffs alleged that defendant’s records failed to support their claims that the general inpatient care was medically necessary. The defendant, Covenant, is a non-profit hospice care provider which operates in Southern Alabama and the Florida Panhandle.

The matter was handled by the DOJ’s Civil Division (Commercial Litigation Branch), the U.S. Attorney’s Office for the Northern District of Florida, the Department of Health and Human Services’ Office of the Inspector General, the Defense Health Agency of the U.S. Department of Defense, the Alabama Attorney General’s Office, and the Florida Attorney General’s Office.The allegations were resolved via settlement for $________ in reimbursement, with no admission or determination of liability. The government will recover $________ for overbilling to Medicare, Tricare, and Medicaid. The states of Alabama and Florida will collectively recover $________ for the overbilling of their respective Medicaid programs.

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