Care Alternatives Must Again Face Whistleblowers’ Hospice Suit

Care Alternatives Inc. must again face a False Claims Act suit alleging that the company defrauded Medicare by providing hospice care to patients who weren’t eligible, the Third Circuit ruled Friday.

A New Jersey federal district court erroneously found in 2021 that the whistleblowers didn’t show that the company’s alleged failure to provide proper medical certification for the services affected Medicare’s decisions to pay, and therefore the suit failed for lack of materiality, Judge Cheryl Ann Krause the US Court of Appeals for the Third Circuit said.

The district court assigned too much weight to a single factor—government action—under the ...