The FBI has issued public warnings about hospice fraud in four states — Texas, Arizona, Nevada and California. The bureau is alerting consumers to a wide-spread scam in which patients are enrolled in hospice without their knowledge by recruiters who “sell” hospice care to people who aren’t actually eligible.
The alarm was sounded about this kind of fraud two years ago by the New Yorker and Pro Publica.
Many of those scammed are poor and don’t speak English.
One reason fraudsters have yet to gain a foothold in New York is that new hospices here go through a “Certificate of Need” process (CON) which reviews applications, provides for public comment and ensures that hospice operators don’t have a history of fraud or abuse.
But according to Jeanne Chirico, president and CEO of the Hospice & Palliative Care Association of NYS (HPCANYS), and Kara Travis, president and CEO of Mountain Valley Hospice & Palliative Care, and a trustee of HPCANYS, there’s more that New York can do to protect consumers.
They are urging lawmakers to pass a bill carried by state Sen. Liz Krueger and Assemblymember Amy Paulin that would prohibit the establishment of new for-profit hospices in the state (A6032 - Paulin / S6460 – Krueger).
“This is a bill that has been passed before by the Legislature but was vetoed by the governor,” Chirico said. “The veto memo asked that the issue be addressed in the Master Plan for Aging, which it was.”
Chirico said that the group that issued the Master Plan for Aging resolved that there was a need to protect New York state from bad actors, all of whom are in the for-profit hospice space.
When asked why hospices have become a target for fraud as well as private equity investors, Travis said they see an opportunity to make money through the hospice benefit.
“We’re an easy target. It’s a vulnerable population and across the country it’s been a very easy target. It’s a way for for-profits to make money,” she said.
The FBI isn’t the only government agency looking into hospice fraud. The Justice Department’s Antitrust Division, Federal Trade Commission and Department of Health and Human Services have jointly launched a cross-government public inquiry into private-equity and other corporations’ increasing control over health care.