Medicare Fraud Suit Against Hospice Care Provider Gets New Life

The False Claims Act suit against a hospice care provider by former employees claiming Medicare fraud may continue, the Fifth Circuit said.

The claims were material, the May 7 opinion by Judge W. Eugene Davis, reversing the district court.

The relators alleged Nurses to Go Inc. didn’t properly certify Medicare patients. They alleged the provider submitted Medicare claims asserting it had, automatically enrolled patients in continuous care—the most expensive care—when they didn’t need it, and billed Medicare for deceased patients. The district court dismissed the suit, saying the allegations were immaterial.

Under the FCA, a claim is material if it ...