SALT LAKE CITY (ABC4) — A Salt Lake County health care company has agreed to pay more than $1 million to resolve allegations that they submitted false claims to Medicare and Medicaid for non-covered hospice services.
According to the United States Attorney’s Office in Utah, Summit Hospice had violated the False Claims Act by knowingly submitting false claims to Medicare and Medicaid between October 1, 2018, and September 7, 2021. The company has agreed to pay a total of $1,045,944.42.
The hospice center was reportedly billing for services that were not medically necessary as the patients did not have documentation of a terminal illness to qualify for those services.
Summit Hospice has denied those allegations.
The U.S. Attorney’s Office says patients can only be eligible for Medicare hospice benefits if they have a medical prognosis stating that they are “terminally ill,” meaning their life expectancy is six months or less if the illness runs its normal course.
The investigation was carried out by the Office of Inspector General at the U.S. Department of Health and Human Services and the Medicaid Fraud Control Unit at the Utah Attorney General’s Office.
“Hospice care is an important service that should provide patients with comfort,” said Curt L. Muller, special agent with the Office of Inspector General. “Providers who focus on personal financial gain rather than providing medically necessary, high-quality care to their patients undermine the integrity of these services.”