Nashville Standard

Gentiva, the successor to Kindred at Home, has agreed to pay $19.428 million to resolve allegations that Kindred at Home and related entities knowingly submitted false claims and retained overpayments for hospice services provided to patients ineligible for hospice benefits under various federal health care programs. Gentiva’s hospice operations, headquartered in Atlanta, include entities that previously operated Kindred at Home hospice locations under the names Avalon, Kindred, SouthernCare, and SouthernCare New Beacon.

“The hospice benefit under Medicare and other federal health care programs provides critical services to some of the most vulnerable patients,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “The department will ensure that this important benefit is used to assist those who need it, and not as an opportunity to line the pockets of those who seek to abuse it.”

The settlement resolves allegations made by the United States and the State of Tennessee in a consolidated complaint filed in 2021 against certain Kindred-related entities. These allegations state that from 2010 until February 2020, defendants knowingly submitted or caused false claims for hospice services provided to Avalon hospice patients in Tennessee who were not terminally ill and thus ineligible for Medicare or Medicaid hospice benefits. Additionally, it addresses claims that defendants improperly concealed or avoided repayment obligations for these services.

Further resolved are allegations involving other Kindred locations: Warwick (Rhode Island), Beaumont (Texas), Independence (Missouri), Demopolis (Alabama), Daphne (Alabama), Mobile (Alabama), South Bend (Indiana), and Youngstown (Ohio). These locations allegedly submitted false claims for non-terminally ill patients' hospice services under Medicare and other federal programs while also concealing or avoiding repayment obligations.

Additionally addressed are accusations against SouthernCare New Beacon for violating the Anti-Kickback Statute by paying remuneration between October 1, 2016, and October 1, 2022, to induce referrals of Medicare beneficiaries to its Gadsden location. This violation was disclosed voluntarily by New Beacon Healthcare Group LLC doing business as SouthernCare New Beacon Hospice.

“Hospice provides vital care and support for terminally ill patients and their families,” said U.S. Attorney Henry C. Leventis for the Middle District of Tennessee. “We are committed to holding accountable health care companies and providers who prioritize profits over patient care by ignoring these requirements.”

U.S. Attorney Michael A. Bennett for the Western District of Kentucky emphasized his office's commitment "to safeguarding public monies" while commending collaborative efforts leading to this settlement.

U.S. Attorney Zachary A. Cunha for Rhode Island stressed ensuring federal funding reaches deserving patients rather than being exploited by healthcare companies.

U.S. Attorney Todd Gee underscored that decisions regarding hospice services should be based on medical diagnoses rather than profit motives.

U.S. Attorney Sean Costello reaffirmed dedication "to protecting federal healthcare programs like the Medicare hospice benefit from false claims."

Deputy Inspector General Christian J. Schrank emphasized accountability among providers prioritizing financial gain over necessary high-quality care.

The settlement involves payments totaling $18,956,151.32 going to the federal government with additional sums allocated to Tennessee ($448,800) and Ohio ($23,618).

Nine lawsuits brought under qui tam provisions led current/former employees filing actions on behalf of the U.S., potentially receiving portions of recoveries yet undetermined.

This resolution resulted from coordinated efforts involving multiple U.S Attorneys’ Offices across several districts alongside HHS-OIG among others emphasizing combating healthcare fraud using tools like False Claims Act allowing tips/complaints via HHS hotline at 800-HHS-TIPS (800-447-8477).

Trial Attorney William E Olson along with various Assistant US Attorneys handled matters ensuring rigorous enforcement without determination liability remains alleged only.