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Common Examples of Hospice Fraud

Hospice fraud can occur in a variety of ways, some common hospice fraud when the hospice provider engages in any of the following acts:

  1. Offering the hospice benefit to a beneficiary who has not been certified by a physician to be terminally ill with a life expectancy of six months or less;
  2. Falsifying patient charts to justify admission or retention of patients;
  3. Falsifying records to fake a physician certification;
  4. Giving gifts to beneficiaries to encourage them to agree to a hospice level of care (although they are unlikely to be deemed as “terminally ill”);
  5. Improperly retaining hospice patients whose health is improving rather than declining;
  6. Keeping patients on hospice care for long periods of time without medical justification;
  7. Inflating the level of care beyond the care a patient actually needs;
  8. Ordering unnecessary equipment and medication.
  9. Billing for higher level of care that was actually provided;
  10. Billing for the most expensive level of hospice care, in-patient crisis care, when it is not medically necessary;
  11. Providing inadequate or incomplete services;
  12. Paying a bonus based on the volume of patients admitted;
  13. Failing to conduct required patient re-evaluations;
  14. Maintaining inadequate medical records that do not justify admission or retention of hospice patients; or
  15. Providing curative care to hospice patients.

California Hospice Fraud Defense Attorney

If you or a loved one is under investigation or has been arrested for federal heath care fraud charges in California, we invite you to contact our federal health care fraud defense attorney at (213) 401-2777 for free consultation.

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