Gentiva / Kindred at Home — Hospice Eligibility
Hospice Provider Pays $19.4 Million for Ineligible Patient Billing
Source: U.S. Department of Justice
TL;DR: Hospice Provider Pays $19.4 Million for Ineligible Patient Billing This case resulted in a $19.4 Million resolution and demonstrates the impact of whistleblower protections in recovering funds from fraud.
Summary
Gentiva (as successor to Kindred at Home) agreed to pay $19.428 million to resolve allegations that Kindred-related hospice entities submitted claims and retained overpayments for hospice services for patients who were not eligible for hospice benefits. DOJ described allegations spanning 2010 through February 2020 involving Tennessee Avalon hospice patients who allegedly were not terminally ill, and additional allegations involving hospice locations in multiple states. DOJ also reported the settlement resolved allegations of an Anti-Kickback Statute violation tied to payments to a consulting physician at one location, and stated the settlement resolved claims across multiple whistleblower suits.
Our Take
Hospice eligibility cases are documentation-and-decision cases: who decided a patient was terminal, what dissent looked like, and how revocations/discharges were handled when patients stabilized. Insiders often have admission packets, CTI support, audit feedback, and communications about census, length-of-stay, and "live discharge" pressure. The pattern DOJ cases often reflect is not a single borderline patient—it's a repeatable approach to eligibility that favors retention over clinical reassessment.
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Notice
The summaries above are based on publicly available information released by the U.S. Department of Justice and are provided for informational purposes only. They do not constitute legal advice, investigative findings, or allegations by Disclosure Strategy. Our commentary reflects general, experience-based observations about how False Claims Act matters commonly arise and is not a statement about any party's liability.