It Only Takes One Bad Egg to Spoil the Whole Basket

Healthcare Fraud , Newsroom
tags

Hospice care was contrived out of the desire to create a model for end-of-life quality, and generally speaking, hospice facilities provide such care without issue. To do so, these facilities generally encompass a team-oriented approach, with focuses on pain management, emotional support, and spiritual devotion – all of which are expertly tailored to the needs and wishes of the patient. In fact, the primary objective of hospice care as a whole is to serve as a compassionate form of “treatment” for individuals that are facing various life-limiting, terminal illnesses or injuries and are expected to pass on within the next couple of months. So what happens when the practitioners who are responsible for providing this treatment lack compassion altogether – or in this case, aren’t even qualified to provide care?

Enter Jada Nicole Antoine, who fits the aforementioned mold all too snugly. Antoine stole the identity of a registered nurse in order to obtain employment at several hospice facilities in the Dallas-Fort Worth area, using her newfound reputation to fraudulently bill Medicare for services not rendered – all for her own financial gain. During the three years in which she ran this elaborate scheme, she saw and purportedly “treated” 243 hospice patients, all the while filing fraudulent claims and thus directly violating the False Claims Act.

Her identity theft, falsified claims, and several other fraudulent activities in which she took part led Heart to Heart Hospice of Texas, Odyssey Healthcare GP, and the other hospice agencies by which she was employed to submit up to $800,000 worth of false claims to Medicare and Medicaid, who ended up reimbursing the hospice agencies in question. In her thoughtless pursuit for personal gain, Antoine victimized not only the facilities themselves, but the hundreds of patients who would have otherwise received an appropriate level of care. According to the investigation, she claimed to have treated patients who were simply unable to be cared for; these patients were later proven to have been asleep, comatose, mentally incapacitated, or unresponsive during the time of her alleged treatment. In multiple other cases, she even falsified assessments of the digestive functions, breathing conditions, and reported comfort levels of patients in order to receive higher reimbursements and to dupe Medicare and Medicaid alike into believing care was actually being provided.

At the end of the scheme, Antoine racked up quite a list of offenses; however, the most despicable of all allegations brought against her remains her disregard for patient lives. She purposely neglected to care for those in need, and in depriving them of such an important end-of-life service, violated their trust and their privacy in the process. It is not unheard of for hospice fraud to lead to unnecessary patient deaths, as was the case in another Texas facility, and had Antoine not been apprehended, it is not a stretch to believe this case could end on equally as tragic terms. Fortunately, she was brought to justice and not only was taxpayer money recovered, but she is no longer able to risk the lives of our most vulnerable citizens.

Hospice fraud, along with various other types of healthcare fraud, runs rampant and creates a skewed image of the already suffering reputation of the medical industry. Hospice care was created with good intention – but the bad eggs like Antoine, who bilk the system for their own profit, make the option a scary one when considering palliative care for loved ones.

Nevertheless, good eggs still exist in the basket. In many cases in which hospice fraud has been detected, the schemes are brought to the attention of the government by others who also find acts like these reprehensible; oftentimes, by employees of the same facilities. This reporting, also known as whistleblowing, ensures that taxpayer dollars are allocated to those who need care – and that those who do, actually receive it.

Whistleblower Justice Network Can Help You

Whistleblower Justice Network partners with whistleblowers to bring to justice those who prioritize financial gain over moral responsibility. We assist individuals who bring forth information about fraudulent schemes in filing cases against those who knowingly risk patient lives in order to illicitly obtain funds.

If you have meaningful information regarding hospice fraud that you believe is in violation of the False Claims Act, Whistleblower Justice Network can help. Working alongside world-class legal counsel, we will ensure you are protected to the fullest extent of the law and that you receive credit for the information you bring to the U.S. government. Partnering with whistleblowers is all we do. Visit us at www.whistleblowerjustice.net, or call us at 844-WJN-4ALL.