Can they do this??

I won't comment on the mini blind affair because I do not know the law on that account, but one other factor does come to mind.

Small town 'politics' are often very, shall we say, 'complex.' Your hospice is clearly sitting in the driver's seat as far as the law is concerned; the PCP in question is clearly way out of bounds... ethically and legally. But however correct you may be, you must think in the long term. You could clobber the guy now, but how will that affect the other physician's in your community in the future?

You are 'in the right'... but sometimes you have to ask yourself, "Would I rather be right... or happy?" Having spent most of my life in small, rural communities, I would suggest you listen to the most politically savvy person in your agency before deciding on a course of action. A quiet discussion in some 'back room' may settle the whole thing to everyone's satisfaction.

Generally speaking, thats always good advice. Seek counsel of those that know the inner workings of things. Please, however know that the tenet of Federal investigations is this: "what did you know and when did you know it?"

This means that those that had knowledge of a federal offense, were it prosecuted, could get dragged in to the situation for not coming forward. It is not unusual in cases like this that the feds will interview direct competitors of those they are investigating simply to compare responses to specific types of questions. Years ago, I was the COO of a HHA company and shortly after 2 new investors joined, the financial statements started to look mighty strange. I verbally questioned the entire accountant staff, assuming there was a software programming error and clearly demonstrating why those numbers could not possible make sense. The problem continued, I went to VP of finance, then the CEO when it became clear this was no error. He was from another industry and might not have caught this, or so I hoped. Bottom line, it was clear to me what they were doing,as the CEO did nothing about it, I resigned and went to the local Inspectors Generals office. By then, I had a paper trail of email and responses, payroll records showing changes of classification from part of the company to the other. Basically, illegal cost shifting. This was pre- PPS.

They were prosecuted heavily, paid fines of a million dollars. Those that I had communicated with early on were personally prosecuted as they knew what they were doing, that someone( me) was questioning it and they continued with it anyway. I was told a year later by the feds what the outcome was and that I would have been prosecuted right along with them had I not come foreward after many attempts to correct the situation.

I understand that business lunches and trinkets dont fall into federal offense category and are normal marketing approaches. But major capital improvements are something else again. Now, if the money for those improvements flowed out of an independently managed foundation,which may have a connection to the competing hospice ,which often occurs, and is structured correctly, thats appropriate and legal. Everyone should know that being genuinely concerned, gathering facts best you can and reporting something is the right thing to do. If you were incorrect, it all quietly goes away, no harm done.