A federal judge says she may toss out a whistleblower lawsuit that claims hospice provider AseraCarefraudulently billed Medicare millions of dollars for patients unless the U.S. Department of Justice can provide more evidence than a mere difference of opinion between medical experts.
Hospice patients must be certified by doctors to be within six months of dying, if their disease runs its normal course, in order to qualify for federal Medicare hospice benefits. The whistleblower lawsuit claims AseraCare submitted false claims for a number of patients, many who stayed in hospice well beyond six months.
The DOJ has said it would seek more than $200 million in Medicare reimbursement, fines and other penalties from the company. Some of the money would go to the whistleblowers in Alabama, Wisconsin and Georgia who first brought the false claims to the government’s attention.
A jury reached a verdict that AseraCare had filed false claims in 104 of 121 patient cases in the first phase of a trial that lasted more than two months. U.S. District Court Judge Karon Bowdre, however, tossed out the verdict last month and ordered a new trial because she believed she had given the jury bad instructions before their deliberations.
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