SALT LAKE COUNTY — A Salt Lake County hospice facility will pay over $1 million to resolve allegations that they violated the federal False Claims Act by submitting claims to Medicare and Medicaid for non-covered services.
Summit Hospice was accused of knowingly submitting claims for payment to Medicare and Medicaid between October 1, 2018, and September 7, 2021 that were deemed "not medically necessary" because the patients’ records lacked sufficient documentation of a terminal illness.
Summit Hospice denies the allegations; entering into a settlement agreement is not an admission of liability.
Hospice care is special, end-of-life care intended to comfort patients, but not treat the underlying illness.
To be eligible for the Medicare hospice benefit, patients must be “terminally ill,” meaning patients are predicted to have six months or less to live.
"Hospice care is an important service that should provide patients with comfort. Providers who focus on personal financial gain rather than providing medically necessary, high-quality care to their patients undermine the integrity of these services," said Curt L. Muller, Special Agent in Charge at the Department of Health and Human Services, Office of Inspector General.
Investigators on the case were from the U.S. Department of Health and Human Services and the Utah Attorney General’s Office.
