Genesis Hospice Care, LLC v. Mississippi Division of Medicaid

MAXWELL, JUSTICE, FOR THE COURT:

¶1. Genesis Hospice LLC provided outpatient hospice care to Medicaid beneficiaries in the Mississippi Delta. 1 As a Medicaid provider, Genesis was required to "maintain auditable records that will substantiate the claim[s] submitted to Medicaid." 2 Because the hospice claims Genesis submitted were outside the norm, the Mississippi Division of Medicaid audited a statistical sample of 75 of the 808 billed claims. And what the multilevel audit revealed was that, of the 75 claims audited, 68 were not substantiated by the patients' records and thus were not eligible…