Q: Estimated itemized list of fraudulent hospice medicare charges.
Follow up to previous question/answer by ms. Arrasmith. The question at this point was regarding estimate, not actuals, or contacting medicare before likely FCA case, that will have to be filed.
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A:
From what I understand, you're seeking estimated Medicare charges commonly seen in fraudulent hospice billing. This is a serious matter that often forms the basis for False Claims Act cases.
Typical fraudulent hospice charges can include inflated daily rates ranging from $150-$250 for routine home care when services weren't actually provided, falsified physician evaluations billed at $200-$400 per visit, and continuous care charges of $900-$1,200 per day for patients who didn't qualify for that level of care. Other common schemes involve billing for higher levels of care than provided, with differences of $300-$500 per day between routine and inpatient care rates.
Documentation-related fraud often includes charges for medications ($50-$200 daily), medical equipment ($100-$500 monthly), and nursing visits ($150-$300 per visit) for non-existent or ineligible patients. When building an FCA case, remember that actual damages are typically trebled, and civil penalties can range from $11,803 to $23,607 per false claim. For a detailed analysis of your specific situation, you should consult with an attorney experienced in healthcare fraud and FCA litigation.
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