LAS VEGAS (KTNV) — A Department of Health and Human Services administrative law judge upheld a decision revoking OneCare Hospice LLC's Medicare enrollment after federal regulators determined the company had an affiliation that "posed an undue risk of fraud, waste, or abuse to the Medicare program."
WATCH | Abel Garcia has the latest on the ruling and what it means:
The ruling, issued July 9, also imposes a 10-year reenrollment bar on the company.
Court documents show OneCare Hospice was affiliated with another Nevada hospice provider, PHHC of Nevada LLC, through a shared medical director, Dr. Charles McSwain.
According to the ruling, PHHC of Nevada LLC's Medicare billing privileges were revoked after federal reviewers examined 10 hospice claims. Nine of those claims were denied. Under Medicare rules, hospice care is generally intended for patients expected to have six months or less to live.
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The judge wrote that because OneCare Hospice was legally affiliated with PHHC of Nevada LLC, it "posed an undue risk of fraud, waste, or abuse to the Medicare program."
The ruling is administrative, not a criminal fraud conviction, and does not state that patients were harmed.
An attorney representing OneCare Hospice said "no comment at this time."
Channel 13 has extensively been investigating hospice-related concerns raising red flags across the valley.
WATCH | Nevada hospice industry under scrutiny as families navigate quality care gaps:
