Tapestry Hospice Execs Settle Fraud Case for $1.4M; Prison Term, $3M Penalty in Angel Care Case

Anti-kickback and health care fraud cases have recently cropped up in two southern states, with hospice personnel facing millions in fines and one owner facing imprisonment for their involvement.

Tapestry Hospice Executives Settle in FCA Case

A federal court in Georgia recently announced that executives at Tapestry Hospice of Northwest Georgia LLC have agreed to pay $1.4 million to settle alleged anti-kickback statute violations of the False Claims Act (FCA).

“Decisions regarding end-of-life care are incredibly difficult and personal, and families must be able to trust the intentions of their chosen providers,” Georgia Attorney General Chris Carr said in a report from the U.S. Justice Department. “Those who instead take advantage of the system for their own personal gain will be held accountable.”

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Located in Calhoun, Georgia, Tapestry Hospice’s service region spans 10 counties in the state. Dr. David Lovell, its founder and owner, launched the for-profit hospice in 2010, and the enterprise became Medicare-certified in 2012. Its average daily census hovers around 125 to 199 patients, according to data available from the National Hospice Locator.

Lovell, along with Stephanie Harbour, executive director at Tapestry Hospice, and other hospice management staff Ben Harbour and registered nurse Andrew Nall, allegedly entered into kickback arrangements with medical directors of other health care organizations in exchange for hospice referrals. The settlement amount resolves the claims of the case without determining liability.

Tapestry Hospice allegedly paid medical directors to “induce them to refer patients” to their organization in exchange for monthly stipends and signing bonuses for medical directors. The alleged charges stipulated that Tapestry Hospice increased compensation to medical directors of other health care organizations for increased patient referrals and decreased wages when hospice referrals lagged.

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An unnamed former employee of Tapestry Hospice raised concerns of the alleged kickback scheme in a qui tam complaint against the organization. Qui tam cases occur when a whistleblower, deemed a “relator” by courts, files a False Claims Act (FCA) suit in concert with the government. The relator can potentially receive a portion of any funds recovered by the government via the lawsuit, typically ranging from 15% to 25%. The relator received $252,000 from the recent $1.4 million settlement.

The FCA case was investigated by the U.S. Attorney’s Office for the Northern District of Georgia, the FBI and the Georgia Medicaid Fraud Control Unit.

“By entering into kickback arrangements, health care providers can cause doctors to make medical decisions that are motivated by financial gain, rather than the patient’s best interest,” said U.S. Attorney Ryan Buchanan.

Prison Sentence Issued in Angel Care Hospice Fraud Case

A federal court in Louisiana has sentenced an Angel Care Hospice owner to serve 72 months in prison for bilking $1.5 million in improper Medicare claims.

Kristal Glover-Wing, the former owner of the Louisiana-based hospice, was found guilty in April of one count of conspiracy to commit health care fraud and three counts of health care fraud.

U.S. District Judge Robert Summerhays on Thursday sentenced Glover-Wing to six years in prison, followed by three years of supervised release. She was ordered to pay upwards of $3.67 million in restitution. Physicians employed by Angel Care were acquitted of any malfeasance.

“As federal prosecutors, we must protect the taxpayer dollar by taking cases of Medicare fraud seriously due to the overwhelming number of Americans that rely on such programs to literally survive,” U.S. Attorney Brandon Brown said in a report. “The defendant in this case took advantage of elderly patients for the benefit of her company as opposed to her clients. We believe this is a fair sentence and we will continue to prosecute cases of fraud and corruption by those who seek to unjustly enrich themselves to the detriment of the elderly and federal government.”

According to the U.S. Justice Department, Angel Care enrolled 24 patients in hospice between 2009 through 2017 who did not meet Medicare eligibility requirements. None of these patients had been diagnosed with a terminal illness, and several are still alive several years later, according to evidence presented at trial.

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) investigated the case in collaboration with the FBI. The case was prosecuted by Assistant U.S. Attorneys Kelly Uebinger, Danny Siefker and Lauren Gardner.

Patients and their family members testified that they had no knowledge of being enrolled in hospice care. One patient reported that Medicare had refused to cover a medically necessary procedure based on their hospice enrollment.

“The sentence imposed today is an affirmation of our commitment to protect the integrity of our nation’s health insurance programs from those who illegally profit through their fraudulent activities,” Jason Meadows, special agent in charge at HHS-OIG. “HHS-OIG will continue to work closely with our federal law enforcement partners and bring to justice bad actors who defraud the Medicare program.”

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