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Hospice fraud: how you can protect your loved ones in hospice care

JACKSON, MISS–In 5 years hospice fraudsters fleeced over $1 billion from Mississippians.

How do they do it? They ask nicely.

The con is simple: a marketer knocks on your door, offering to provide better medicare coverage (often for free), followed by a quick peek at your Medicare card. This should send up a red flag, but for some it unfortunately does not.

According to Chris Covington, Assistant Special Agent with the US Department of Health and Human Services, “hired gun” doctors often take financial incentives to write new plans for people that aren’t even their patients and aren’t even terminally ill.

“Mississippi has had over $1 billion dollars paid in hospice benefits over the past 5 years,” said Covington. “We are committed to stamp out Medicare fraud in Mississippi, and hospice fraud is a focus area.”

Covington said oftentimes fraudulent providers will bill a patient for hospice services they do no need. Services like light housework and taking blood pressure are being billed to Medicare patients who are not dying, and have no need for hospice services. These people end up becoming ineligible for services later: pawns to a scheming con artist.

So far, the most prolific case was that of Angelic Hospice in Greenwood which charged over $8 million in fraudulent services.

“They billed $12 million,” said Covington. “And $8 million of that was fraud.”

In the end, the owner of that hospice was paying a medical records clerk for patient information, then simply forging a doctor’s signature to secure certification orders. On average, they were receiving $15,000 per beneficiary.

The takeaway from this is to treat your Medicare number the same way you treat a credit card number. If you need a service, your DOCTOR will be the one to write your prescription for it.

If you feel like you or someone you know has been the victim of hospice fraud, call the Dept. of Health and Human Services. You’ll be routed to an investigator that will ask you to give a description of the marketer, what kind of car they were driving, and what kind of service they are offering.

According to the Center for Medicare Services, acts of physical abuse or fraud should be reported to the State Medicaid Fraud Control Unit (MFCU) or State Medicaid Agency (SMA). Information on contacting your State MFCU or SMA is available on the CMS website.

A loved one can file a complaint with the State Survey Agency and/or the CMS Regional Offices.

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