Oregon Hospice Pays U.S. $1.83 Million to Settle False Claims Act Liability

WASHINGTON, Nov. 12 /PRNewswire-USNewswire/ -- Kaiser Foundation Hospitals -
Kaiser Sunnyside Medical Center, Kaiser Foundation Health Plan of the
Northwest and Northwest Permanente P.C., Physicians & Surgeons (collectively,
Kaiser NW) has agreed to pay the United States $1,830,322.41 to settle False
Claims Act liability, the Justice Department announced today. The United
States contends that Kaiser NW billed Medicare between 2000 and 2004 for
hospice services that had been provided by the Kaiser Northwest Region Hospice
without obtaining written certifications of terminal illness required under
the federal health care program.

Medicare hospice care providers like Kaiser Northwest Region Hospice must
obtain written certifications of terminal illness for each hospice
beneficiary's initial certification period (the first 90 days of care) from
the medical director of the hospice and the individual beneficiary's attending
physician, if the beneficiary has one. Medicare requires a hospice to obtain
these certifications prior to billing Medicare in order to help ensure that
hospice care is medically necessary.

In June 2005, Kaiser NW submitted a report to the Department of Health and
Human Service's Office of Inspector General disclosing that between October
2000 and March 2004, there were instances in which Kaiser NW did not obtain
written certifications of terminal illness for hospice beneficiaries prior to
billing Medicare for the beneficiaries' initial certification period. The
settlement announced today resulted from the company's disclosure.

"By requiring that health care providers comply with Medicare's standards, we
ensure that beneficiaries receive hospice care that is medically necessary and
meets appropriate medical standards," said Tony West, Assistant Attorney
General for the Justice Department's Civil Division. "We encourage disclosures
of this nature and we consider them essential to ensuring the protection of
the Medicare Trust Fund."

"This settlement furthers the strong public interest in protecting the
integrity of the Medicare program and ensuring the appropriateness of hospice
care for Medicare beneficiaries," said Kent Robinson, Acting U.S. Attorney for
the District of Oregon.

The case was handled by the Justice Department's Civil Division, the Acting
U.S. Attorney for the District of Oregon and the Office of Inspector General
of the Department of Health and Human Services.

SOURCE U.S. Department of Justice

U.S. Department of Justice Office of Public Affairs, +1-202-514-2007, TDD
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