WASHINGTON (Oct. 7, 2015) — Whistleblower Cheryl Sifford will receive 20 percent of $2.2 million repaid to taxpayers in the U.S. government’s settlement of fraud claims against an Arizona hospice operator that was accused of admitting Medicare patients who weren’t properly certified for end-of-life care — including some patients who weren’t even terminally ill.
The Employment Law Group® law firm represented Ms. Sifford in the civil case, which alleged that Phoenix-based Serenity Hospice and Palliative Care routinely billed the U.S. government for the treatment of patients who didn’t meet standards for hospice care under its Medicare insurance program.
Ms. Sifford, an experienced hospice nurse, resigned as Serenity’s vice president of clinical operations after questioning its practices.
In order to be eligible for end-of-life treatment, Medicare requires that patients have a medical condition that, under normal circumstances, results in a life expectancy of six months or less. Switching to hospice care — which includes pain management and other palliative measures — is a serious step for patients: Medicare no longer pays for any treatment designed to cure them.
According to Ms. Sifford’s amended complaint in the case, Serenity admitted a steady stream of Medicare patients without any real investigation of their condition. It ended up treating many patients for more than a year, and some for more than 30 months.
The U.S. Department of Justice today announced the terms of its settlement with Serenity and its founder and former president Ruth Siegel. In addition to paying the government, Serenity agreed to be governed by a five-year “corporate integrity agreement” — and Ms. Siegel, who has left Serenity, was barred from receiving money from any federal health program for five years.
“By blowing the whistle on this behavior, Cheryl showed her integrity as a nurse — and as a citizen,” said David L. Scher, a principal of The Employment Law Group and lead attorney on the case. “Even though she ended up quitting as a result, she demanded proper treatment for her seriously ill patients and a proper accounting for her fellow taxpayers, who were covering the bills.”
Ms. Sifford filed a complaint in 2014 against Serenity and Ms. Siegel under federal laws including the False Claims Act. That statute, originally signed into law by President Abraham Lincoln in 1863, makes it illegal to deceive the federal government for financial gain.
The law includes a “qui tam” provision that allows whistleblowers to file a legal complaint on behalf of the government and — if they prevail — to receive a share of the proceeds.
“The behavior that Cheryl uncovered at Serenity is, sadly, not unusual in the hospice industry, particularly in states such as Arizona and Florida,” said R. Scott Oswald, managing principal of The Employment Law Group. “Patients with serious illnesses deserve to get properly individualized treatment — not to be treated as a commodity, valued only for the revenue they provide for unscrupulous operators. Thanks to Cheryl, we’ve moved a step closer to that ideal.”