Jackson, Miss – Andre Kirkland, 52, of Cleveland, Mississippi was sentenced in U.S. District Court in Oxford on September 1, 2016, on charges that he defrauded Medicare and Medicaid by signing up patients for hospice care who were not terminally ill, announced U.S. Attorney Gregory K. Davis, FBI Special Agent in Charge Donald Alway, Special Agent in Charge Derrick L. Jackson with the U.S. Department of Health and Human Services Office of Inspector General, and Mississippi Attorney General Jim Hood.
Kirkland, who owned and operated Revelation Hospice in Clarksdale, pled guilty on May 4, 2016, to conspiracy to commit health care fraud. U.S. District Judge Michael Mills sentenced Kirkland to serve 48 months in home confinement in lieu of imprisonment due to recurrent metastatic cancer, which requires substantial medical care. Kirkland was also ordered to pay restitution in the amount of $5,400,843.50 to Medicare and $66,171.43 to Medicaid.
The investigation revealed that Andre Kirkland and Revelation Hospice were knowingly enrolling non-hospice eligible Medicaid and Medicare recipients and then filing false hospice claims to Medicaid and Medicare for services that were not medically necessary or were not ever provided. Kirkland, as a registered nurse and Revelation’s Director of Nursing, personally admitted non-hospice appropriate Medicaid and Medicare recipients into Revelation and deceived the patients about the true nature of the services in which they were being enrolled. As part of this deception, many patients unknowingly signed Do Not Resuscitate forms along with undated hospice revocation forms. Kirkland would later use the revocation forms to discharge patients from Revelation Hospice without the patient’s knowledge.
As the Director of Nursing for Revelation, Andre Kirkland was responsible for hospice admissions and the supervision of all nursing staff. He also treated patients in the field. According to patient interviews, Kirkland deceived patients about the true nature of the services they were being enrolled in and never told the patients that they were terminally ill. Most of the patients enrolled in hospice care were not terminally ill and were therefore not eligible for hospice care. For example, one of the patients enrolled was a 29-year-old pregnant female who was not terminally ill and was not in any way hospice eligible. She remains in good health today, years after Kirkland fraudulently enrolled her in hospice care.
A medical review of a 30-patient Medicare patient sample revealed that 100% of those patients were not eligible. The revelation had a live discharge rate of 93.30%, meaning that 93.30% of patients enrolled were discharged from Revelation Hospice while still living. By comparison, 2010 data shows that the national average live discharge rate for hospices is 18.2%.
“The health care fraud perpetrated by this defendant was an abuse of public trust motivated by greed. Patients were deceived into being signed up for services intended to help those with terminal illnesses. We remain committed to protecting the integrity of our health care system and will continue to strictly enforce our federal health care laws,” said U.S. Attorney Gregory K. Davis.
“Health care fraud costs our country billions of dollars each year, and the FBI will continue to seek out those that extort health care in the United States,” said Donald Alway, special agent in charge of the FBI in Mississippi. “These are not victimless crimes because health care fraud harms our overall economy. The FBI and our partners are committed to identifying and charging those that engage in this type of activity.”
“Hospice fraud has reached epidemic proportions in Northern Mississippi,” said Derrick L. Jackson, Special Agent in Charge at the U.S. Department of Health and Human Services, Office of Inspector General. “Patients are being falsely diagnosed as terminally ill in order to line the pockets of hospice owners who are treating Medicare like their own personal ATM.”
“Joint investigations have proven to be an essential tool in the fight against fraud in health care benefit programs,” Attorney General Jim Hood said. “We will continue to work with our federal and state partners in this ongoing battle to protect our most vulnerable citizens.”
The case was investigated by the United States Department of Health and Human Services Office of the Inspector General, the Medicaid Fraud Control Unit of the Mississippi Attorney General’s Office, and the Federal Bureau of Investigation. It was prosecuted by Assistant U.S. Attorney Dave Fulcher.