Geisinger Community Health Services to Pay $18M to Settle Hospice Billing Violations

HARRISBURG, Penn (November 5, 2021)—The United States Attorney’s Office for the Middle District of Pennsylvania announced that Geisinger Community Health Services (GCHS) has agreed to pay $18 million+ to resolve allegations of civil liability for submitting claims to Medicare for hospice and home health services that violated Medicare rules and regulations. GCHS voluntarily disclosed the violations.

According to the voluntary disclosures, between January 2012 and December 2017, through several affiliated entities, GCHS submitted claims to Medicare for hospice and home health services that violated Medicare rules and regulations regarding physician certifications of terminal illness, patient elections of hospice care and physician face-to-face encounters with home health patients. After it discovered the problems, GCHS took corrective action and disclosed the matter to the United States Attorney’s Office.

“The $18 million payment in this matter reflects the priority healthcare providers should place on making sure they closely follow all Medicare rules and regulations,” said Acting U.S. Attorney Bruce Brandler. “Healthcare fraud remains a focus of the Department of Justice and the Affirmative Civil Enforcement Unit of the United States Attorney’s Office.  I commend GCHS for taking this seriously, voluntarily disclosing these issues to our office and working to address the problems that led to these violations.”

This matter was handled by the Department of Health and Human Services (HHS), Office of Counsel to the Inspector General (OCIG), the Justice Department’s Civil Division Commercial Litigation Branch, Fraud Section, and AUSA Tamara Haken of the Affirmative Civil Enforcement Unit of the U.S. Attorney’s Office for the Middle District of Pennsylvania.