2015 Annual Training Conference & Anti-Fraud Expo

Sessions Speakers Exhibitors Show Specials Floor Plan Buzz

Hospice Storm Project: Identifying Hospice Fraud in the Medicaid Program (Room Seaport B)

The presentation will focus on the epidemic of hospice fraud in Mississippi with an emphasis on the 'Hospice Storm' project which seeks to identify, investigate and prosecute fraudulent hospice providers. The workshop will begin with an overview of hospice fraud in Mississippi which often originates with door-to-door solicitations by patient recruiters and collaboration by 'medical directors' who are paid by hospices to falsely certify that patients are terminally ill. There will be a general discussion of techniques to identify potentially fraudulent hospices using data analytics such as finding patients who have been on the benefit for extended periods of time. The remainder of the presentation will be a case summary of the successful investigation of Angelic Hospice. The owner of this hospice pled guilty to an $8 million fraud and was sentenced to nearly 6 years in prison in December 2014.