Youngstown hospice nurses help alert feds on alleged insurance fraud; company pays settlement
A national hospice company is to pay nearly $20 million to settle a dispute after claims that its facilities were charging people who didn’t qualify for hospice coverage on government insurance programs.
The U.S. Department of Justice announced on July 17 that federal prosecutors had settled with Gentiva, formerly known as Kindred at Home, after more than 20 whistleblowers — including two hospice nurses from Youngstown, Ohio — alerted the government for alleged fraud.
The nurses, Jason Medved and Anthony Donnadio, will receive a portion of the payout for reporting the fraud at a Youngstown hospice via a lawsuit they filed in 2023 under the federal False Claims Act (FCA).
“As registered nurses, Jason and Anthony owed a duty to their hospice patients first and foremost,” Janel Quinn, a principal of The Employment Law Group said. “They were advocates for ethical medicine, even when it wasn’t easy. This settlement is a fitting recognition of their professionalism and their bravery.”
What are the fraud accusations?
The law states that in order to be reimbursed by taxpayer-funded programs such as Medicare, hospice facilities must claim payment only for patients whom a doctor expects to die within six months.
Medved, Donnadio and the other whistleblowers reported that, Kindred/Gentiva facilities pressured staff to admit patients who were “plainly ineligible” for hospice care — and who sometimes didn’t seem sick at all.
Medved and Donnadio listed multiple cases where patients were diagnosed with conditions such as late-stage Alzheimer’s disease, cirrhosis of the liver or chronic obstructive pulmonary disease but did not have symptoms or laboratory results consistent with such diagnoses.
According to the nurses’ complaint, several patients left the Youngstown hospice after learning they weren’t fatally ill.
What was Gentiva’s Response?
Gentiva denied the allegations but agreed to settle nine separate lawsuits, paying almost $19 million to the U.S. government, almost $450,000 to the state of Tennessee and more than $23,600 to the state of Ohio.
In all, the settled allegations spanned seven states and included both fraud and kickbacks.
About $2.13 million of total recovery was attributed to the Ohio claims pressed by Medved and Donnadio, both of whom resigned from the Youngstown facility, which operates under Gentiva’s SouthernCare Hospice Services brand.
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