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Alabama hospice settles fraud claims of $24.7M
SouthernCare Inc. and its shareholders agreed to pay the United States a total of $24.7 million to settle allegations that the company submitted false claims to the government for patients treated at its hospice facilities, the U.S. Justice Department reported in mid-January.
SouthernCare, based in Birmingham, AL, operates about 99 locations that provide hospice services in 15 states.
"The Medicare hospice benefit is intended to provide compassionate end-of-life care to teriminally ill patients," said Gregory G. Katsas, assistant attorney general of the civil division. "This settlement sends a clear message that the Department of Justice will not allow health care providers to take advantage of beneficiaries in their attempts to game the reimbursement system."
The settlement results from two qui tam suits filed by two former SouthernCare employees, on behalf of the United States.
The False Claims Act authorizes private parties to file suit against those who defraud the United States and to receive a share of any recovery. The United States will pay $4.9 million to the individuals who filed the actions against SouthernCare.
"Our investigation showed a pattern and practice to falsely admit patients to hospice care who did not qualify and to bill Medicare for that care. This resulted in taxpayers bearing inappropriate costs," said Alice H. Martin, U.S. Attorney for the Northern District of Alabama.
New guidelines published for prescribing opioid meds
A panel of pain management experts representing the American Pain Society (APS) in Glenview, IL, and the American Academy of Pain Medicine also in Glenview, IL, has published what they call "the first comprehensive clinical practice guideline" to assist clinicians in prescribing opioid pain medications for patients with chronic non-cancer pain.
The guidelines were published in a recent issue of The Journal of Pain.
"The expert panel concluded that opioid pain medications are safe and effective for carefully selected, well monitored patients with chronic non-cancer pain," said Gilbert J. Fanciullo, MD, a panel co-chair and director, Section of Pain Medicine, Dartmouth Hitchcock Medical Center.
APS, AAPM, and the Oregon Evidence-based Practice Center at Oregon Health and Science University collaborated for two years reviewing more than 8,000 published abstracts and non-published studies to assess clinical evidence from which their recommendations are based.