Three people who ran or served hospice operations around Los Angeles are charged with schemes that prosecutors say fraudulently billed Medicare more than $138 million for patients who were not terminally ill. One of the three is accused of running a hospice that discharged about 85 percent of its patients for reasons other than death. The cases are part of the October 22 federal takedown announced by the U.S. Attorney’s Office in Los Angeles, and all charges are allegations.
A hospice that sent most patients home alive
Geoffrey Jimenez, 60, of Los Angeles, is charged by criminal complaint over Transitions Hospice Inc. Prosecutors say the company billed Medicare about $9.8 million and was paid more than $8.3 million. Its rate of discharging patients for reasons other than death was roughly 85 percent, which the release says is more than four times the national average.
The complaint goes beyond that one company. Prosecutors say Jimenez controlled more than a dozen other hospice entities that billed over $107 million, some with non-death discharge rates above 90 percent. The Medicare hospice benefit is built for patients expected to live six months or less, so a discharge rate that high stands out against the program’s own purpose.
What Medicare requires before hospice care starts
Medicare hospice is meant for people with a life expectancy of six months or less. Medicare says the hospice doctor and the patient’s regular doctor, if there is one, must certify that, and the patient must sign a Hospice Election Statement before any hospice service begins. By signing, the patient agrees to comfort care in place of treatment aimed at curing the illness…