Hospice Care is Now a Money Machine at the Expense of the Dying
In 2018, CNBC’s American Greed, a show that examines how far some people go to become rich, profiled Chicago hospice owner Seth Gillman who makes a killing by padding Medicare bills and claiming many of his patients are sicker than they actually are.
If the idea sounds outrageous and egregious, it should. But the more surprising take is that it’s not all too uncommon.
Hospice care, initially introduced in 1974 and designed to provide comfort and support to terminally ill patients and their families, has become a $22 billion industry funded by taxpayers in the United States.
According to a report from ProPublica and The New Yorker, “Half of all Americans now die in hospice care. Easy money and a lack of regulation transformed a crusade to provide death with dignity into an industry rife with fraud and exploitation.”
Simply put, hospice care is now a money machine.
Why Is Hospice Care Such a Lucrative Business?
Did you know that hospice care centers used to operate as non-profit organizations? Now nearly 70 percent of hospice providers are for-profits today versus just 30 percent in 2000. The Medicare margins for for-profit hospices are reportedly three times higher, which means companies earn large sums of money for relatively low effort.
Medicare pays a set rate per patient per day, regardless of the care provided. Since most hospice care takes place at home and nurses are only required to visit patients twice a month, it is relatively easy to keep overhead costs low and outsource most of the labor to unpaid family members.
For-Profit Hospice Care Provides Fewer Services, Charges More
Another major problem with for-profit hospice care is it is prone to fraud and inaccurate billing. A report by the Office of Inspector General found that of hospice beneficiaries in nursing facilities, hospices provided “fewer services than outlined” for 31% of claims. The report also found that hospices often charged patients for general inpatient care, the second most expensive level of hospice care, when the patients only received home care. This upcharge can reportedly make as much as $521 more per day for the hospice.
Families Complain of Abuse and Criminal Conduct
In addition to fraud and inaccurate billing, for-profit hospices have also been found to have higher rates of no-shows and substantiated complaints from patients and their families than their non-profit counterparts. They are more likely to discharge patients alive when they approach Medicare’s reimbursement limit. This limit states that patients must die within six months of receiving hospice care, or else Medicare may demand repayment. In one criminal case, a hospice owner was even accused of ordering staff to overdose patients who had been in hospice care for too long.
How You Can Hold These Corporations and Providers Accountable
Corporations see dollar signs in traditional healthcare services and take advantage of lax government oversight to generate billions in profit. Along the way, corners are cut, and patients suffer, often the most vulnerable among us. Clearly, the corporate takeover of hospice care has led to exploitation and a lack of oversight in the industry.
Stricter regulations must be put in place to ensure that hospice care is provided in a way that is ethical and truly meets the needs of patients and their families. If you or someone you know has been affected by this egregious abuse of power and you wish to discuss the specifics of your case in a free consultation with an experienced Tucson personal injury lawyer, please contact us today.