Hospice Eligibility Remains A Focus For Federal Prosecutors – Philadelphia Nurse Convicted In Hospice Healthcare Fraud

Posted On Tuesday, February 16, 2016
By: James W. Kraus

On February 8, a federal jury convicted Patricia McGill, a Philadelphia registered nurse, on four counts of healthcare fraud.  The charges arose out of her service as Director of Professional Services for Home Care Hospice (HCH), a for-profit hospice service provider for patients in nursing homes and private residences.  The charges against McGill related to her authorization and supervision of the admission of inappropriate and ineligible patients for hospice services, which contributed to HCH submitting millions of dollars in fraudulent claims to Medicare.

According to the government, HCH billed Medicare for approximately $9,328,000 in hospice services purportedly provided by HCH nurses and health aides.  With the jury’s verdict, however, the government’s evidence established that many HCH patients did not meet Medicare criteria for hospice care and that HCH billed Medicare for hospice care that was not provided to patients.

According to a report by Philly.com, the owners of HCH, identified in other reports as Matthew Kolodesh and Alex Pugman, were tried separately, convicted and sentenced to prison terms last year.  According to the same report, several nurses who worked under McGill’s direction have also been tried and convicted of charges arising out of the same case.

Ms. McGill is scheduled to be sentenced before U.S. District Court Judge Eduardo C. Robreno on May 24, 2016. According to the government, McGill faces a potential advisory sentencing guideline range of 33 to 41 months in prison.