Elizabeth Hogue, Esq. Articles
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Articles:
Negligent Home Care Nurse Charged With Manslaughter
The following article is about a home care nurse whose negligent care of a patient resulted in criminal charges.
Home care nurses; including those who provide Medicare-certified home health services, hospice and palliative care, and private duty services; are vulnerable to professional liability claims, according to “Nurse Professional Liability Exposure Claim Report: 4th Edition,” which was issued by Nurses Service Organization and CNA. The report says that malpractice claims against home care nurses are likely to be based on:
- Failure to communicate pertinent health information with providers and/or patient/family members
- Failure to monitor
- Documentation deficiencies, including failure to document or falsifying documentation
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Further Update Post-AseraCare: Use of Physician Experts to Prove False Claims
The following article is about a recent court decision about false claims submitted to the Medicare Program.
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AseraCare, a hospice provider, defeated allegations in a federal trial court that it knowingly submitted false claims to the Medicare Program for patients who were not terminally ill. On appeal, the Appellate Court emphasized that one physician’s testimony on behalf of the government against AseraCare that contradicted physicians who certified patients for hospice care was insufficient to prove falsity under the federal False Claims Act (FCA). The Court said:
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Recent Case Shows That Providers Must Pay Attention to Concerns About Fraud Raised by Employees
The following article is about employees who were fired for complaining about possible fraudulent activities and then filed a whistleblower lawsuit.
Two former Amedisys employees claim that they were fired in retaliation for alerting management to possible violations of the federal False Claims Act. They then filed a whistleblower, or qui tam, lawsuit [Pilat v. Amedisys, Inc., No. 23-566 (2d Cir. Jan. 17, 2024)]. In their whistleblower suit, the employees claim that they complained internally to supervisors about suspected fraudulent practices and refused to engage in such practices.
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Enforcers Target Discharge Planners/Case Managers Yet Again
Case managers/discharge planners continue to come under fire from fraud enforcers for violations of the federal anti-kickback statute. This statute generally prohibits anyone from either offering to give or actually giving anything to anyone in order to induce referrals. Case managers/discharge planners who violate the anti-kickback statute may be subject to criminal prosecution that could result in prison sentences, among other consequences.
