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Illinois hospice charged in $125M fraud case

January 28, 2014
by Pamela Tabar, Editor-in-Chief
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The owner of an Illinois hospice services provider is facing charges of defrauding Medicare and Medicaid of millions in false hospice payments. Federal prosecutors allege that Seth Gillman, the administrator and one-quarter owner of Passages Hospice, Lisle, Ill., knowingly encouraged employees to document claims for hospice care that exceeded what was medically necessary and/or was beyond the care that actually took place.

According to the Federal Bureau of Investigation release on the case, Passages received more than $125 million in payments from Medicare or Medicaid from 2008 to 2011. Among the 4,700+ hospice patients whose bills are included in the fraud case, many were admitted to hospice care without terminal diagnoses and/or were receiving hospice care for years—far exceeding the “six month or less” life expectancy required for hospice placement.

In addition to fraudulent billing, Gillman is also accused of training his employees “to look for signs that allegedly would qualify a hospice patient for general inpatient care (GIP), resulting in higher payments per day, compared to routine care,” and then giving large bonuses to the Passages’ directors who had the most GIP cases under their supervision, the FBI document notes.

Passages has no physical inpatient facility of its own but maintains business relationships with multiple nursing homes across the state. Gillman also is accused of paying eight nursing homes $250 a day for each hospice patient using a GIP claim.



Passages Media specialist Kamie Freeland emailed this comment to me, reminding us all that the actions of a few individuals do not reflect an entire organization:

"I am contacting you the behalf of Passages Hospice. I would like an opportunity to explain the dedication our current employees and volunteers have to delivering exceptional end of life care to our patients and families.

I pride myself on saying, I work for such a compassionate and innovative company. The true reflection of Passages is our company's current employees and volunteers. I have personally witnessed our teams in action and can truly say I have never seen a more dedicated group. I wish you could see for yourself the kind of people that work for Passages today, because I know I will never be able to express the level of devotion each employees gives to making sure a patient is comfortable and lives out the remainder of their life with respect and on their terms.

The allegations that were released are not a reflection of Passages Hospice, but an individual. I hope you will take the time to read our official statement on our website []."

Thank you for your consideration,
Kamie Freeland
PR and Media Specialist
Passages Hospice