Metropolitan Jewish Health System Hospice and Palliative Care (“MJHS Hospice”), a New York nonprofit hospice provider, has agreed to pay the United States $4,850,000 to resolve civil allegations that it billed Medicare and Medicaid for services rendered to hospice patients at heightened levels of care for which the patients did not qualify, in violation of the False Claims Act, and has agreed to pay the State of New York $375,000. The settlement resolves allegations that MJHS Hospice knowingly billed Medicare and Medicaid for unnecessary levels of hospice care to patients. After an extensive investigation, the United States determined that from 2011–2015, MJHS falsely claimed that some of its patients required CHC and, in 2012, falsely claimed that some patients required GIP. The allegations were brought to the government’s attention through the filing of a complaint pursuant to the qui tam provisions of the False Claims Act.
