Some people know from an early age that their life's work will be devoted to bettering the lives of others. This type of work can take many forms, including teachers, doctors and humanitarians. One man, apparently inspired by the poor treatment of his grandmother, claims that his way of doing this was by providing care to those who are near the end of their lives by running a network of hospices in Illinois. However, prosecutors, who have accused the man of health care fraud, claim that his goal was actually to make money.
According to documents filed against the man, he allegedly trained nurses to find reasons to claim that patients receiving hospice care required inpatient care. Prosecutors claim that Medicare was billed over four times more than required in some cases. He was allegedly compensated for this behavior by awarding himself large bonuses.
Nurses working for nursing homes and the hospice network controlled by the accused man claim that supervisors strongly encouraged them to falsify documents detailing the level of care needed by the patients. One woman even said she falsely noted on the charts of two patients that they required additional treatment as result of falls. In addition to the health care fraud charge, the man has been charged with obstructing a federal audit.
It is unclear at this time what evidence the prosecution has to support their claims of health care fraud or if the nurses and other supervisors mentioned in the court documents will also face criminal charges. Prosecutors will have to provide enough evidence to prove the charges against the Illinois man beyond a reasonable doubt, a difficult standard to meet. Throughout the criminal procedures, the man's rights must be carefully preserved to ensure that he receives the fair trial to which he is entitled.
Source: Chicago Tribune, Hospice owner charged with Medicare, Medicaid fraud, Jason Meisner, Jan. 27, 2014