WASHINGTON - Covenant Hospice, a non-profit hospice care provider which operates chiefly in the Florida Panhandle and Southern Alabama, will pay back $10,149,374 to reimburse the government for alleged overbilling of Medicare, Tricare and Medicaid for hospice services.


WASHINGTON - Covenant Hospice, a non-profit hospice care provider which operates chiefly in the Florida Panhandle and Southern Alabama, will pay back  $10,149,374 to reimburse the government for alleged overbilling of Medicare, Tricare and Medicaid for hospice services.



The U.S. Department of Justice (DOJ) made the announcement Thursday. 



 “The hospice benefits provided by federal health care programs are intended to provide comfort and care to patients nearing the end of life,” said Principal Deputy Assistant Attorney General Benjamin C. Mizer of the Justice Department’s Civil Division.  “We will continue to ensure that these benefits are used for their intended purposes.”



The settlement comes after allegations that between Jan. 1, 2009, and Dec. 31, 2010, Covenant Hospice improperly submitted hospice claims for general inpatient care that should have been billed at the routine home care level for Medicare, Tricare and Medicaid patients.  The government alleged that Covenant Hospice Inc.’s medical records did not support the medical necessity of the general inpatient care.



“Careful and correct claims for reimbursement from critical federal health care programs are essential to the health of our economy,” said U.S. Attorney Pamela C. Marsh of the Northern District of Florida.  “Those public servants who worked hard to investigate the conduct and obtain this settlement deserve our deepest gratitude.  We will continue our efforts to ensure that federal dollars intended for compassionate care and legitimate patient needs are protected.”



The Washington County News reached out to Covenant Hospice after DOJ released its statement Thursday and was told the provider self reported the errors.



"Hospice care is provided at four different levels: routine home care, continuous home care, inpatient respite care and general inpatient," the provider replied via an official statement. "General inpatient care is paid at a higher rate than routine home care. During 2009 and 2010, Covenant Hospice submitted general inpatient claims on a number of patients.  While these patients were hospice appropriate, the medical records documentation only supported the routine home level of care."



"Upon discovery, we self-reported this information to the Department of Justice and conducted extensive training with our entire staff," added Liz Kuehn, Vice President, Organizational Excellence and Corporate Compliance.



“We have been working closely with the Office of the Inspector General to return these payments.  Covenant’s programs and services have maintained a high level of quality to our patients and families,” said Jeff Mislevy, Covenant Hospice President and CEO, who joined the organization in 2014.



Covenant settled with the Department of Justice on the common law theory of payment by mistake and was released from any civil claim.  The settlement did require a repayment of $10.1 million dollars.  In anticipation of the resolution, Covenant Hospice began reserving funds immediately upon discovery, and states this repayment does not impede any current services.