Wednesday, August 23, 2017

Physician Gets Prison for Phony Hospice Certifications

OXFORD, Miss. (AP) — A Mississippi physician was sentenced Thursday to 39 months in federal prison and ordered to pay nearly $2 million in restitution to the federal Medicare program, part of a continuing investigation into fraud by end-of-life hospice care providers in Mississippi.

Dr. Nathaniel Brown of Cleveland pleaded guilty in January to guilty to one count of conspiracy to commit health care fraud, admitting he certified patients as terminally ill and thus appropriate for hospice care, when in fact those patients were not terminally ill. He was sentenced Thursday in Oxford.

One sign of hospice fraud is the share of patients that don't die while under hospice care but are instead discharged. The U.S. Center for Medicaid and Medicaid Services found that in 2014, Mississippi led the nation in live discharges, with 20.4 percent of patients outliving hospice care.
That compared with a national rate of 11 percent that year. The share fell in 2015, to 17.9 percent, but Mississippi still ranked third among the states.

The U.S. Department of Health and Human Services has led a multiyear investigation into fraud in Mississippi called Hospice Storm. Assistant U.S. Attorney Clay Dabbs has called hospice fraud a "runaway problem" in Mississippi, and at least eight people have been charged in the state since 2014. Angelic Hospice owner Regina Swims-King was sent to prison for nearly six years and ordered to pay back nearly $8 million.

Brown, who was the medical director of two Mississippi hospices, received $47,750 in payments by check, plus additional cash. Those hospices, in turn are alleged to have received $1.94 million in inappropriate payments from Medicare.

Two other people involved in those hospices have also pleaded guilty to federal charges.

Sandra Livingston pleaded guilty in 2015 and was sentenced to three years in prison and $1.1 million in restitution. Lara Lynn Thompson, a nurse who recruited patients for both of Livingston's hospices, pleaded guilty in 2015 and was sentenced to 13 months in prison. She shares the $1.1 million in restitution with Livingston, with $272,000 assigned to Thompson and $737,000 assigned to Livingston.

Criminal charges against Livingston say she took $600,000 from the scheme and gave another $200,000 to relatives.

Investigators say people sometimes go door-to-door to solicit patients. Thompson was such a runner. The recruiter then takes patients to be certified by a medical director, such as Brown.

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Physician Gets Prison for Phony Hospice Certifications