Nurse convicted for major hospice Medicare fraud

A federal jury convicted a registered nurse who took part in a multimillion-dollar fraud on Medicare that involved hospice care, announced Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division and U.S. Attorney Zane David Memeger of the Eastern District of Pennsylvania.

Patricia McGill, 68, of Philadelphia, was found guilty yesterday of four counts of health care fraud. U.S. District Court Judge Eduardo C. Robreno of the Eastern District of Pennsylvania set sentencing for May 24, 2016.

The evidence at trial showed that between 2005 and 2008, McGill was the director of professional services for Home Care Hospice (HCH), a for-profit business that provided hospice services for patients at nursing homes, hospitals and private residences. McGill authorized and supervised the admission of inappropriate and ineligible patients for hospice services, which contributed to HCH submitting millions of dollars in fraudulent claims to Medicare.

HCH billed Medicare for approximately $9,328,000 in hospice services that were allegedly provided by HCH nurses and health aides for patients at nursing homes, hospitals and private residences. However, the government’s evidence established that many HCH patients did not meet the Medicare criteria for hospice care and that HCH billed Medicare for hospice care that was not provided to the patients.

The FBI and the Department of Health and Human Services Office of Inspector General investigated the case. Trial Attorney Marty Woelfle of the Criminal Division’s Organized Crime and Gang Section and Assistant U.S. Attorney Frank Labor of the Eastern District of Pennsylvania are prosecuting the case.