Home Health & Hospice Week

Plus: One codefendant pleads guilty while another pleads innocent in Boston.

Many home health agencies’ worst nightmare came true for a provider in Oak Ridge, Tennessee this week.

Federal Bureau of Investigation agents carried out “court-authorized activity” at the Patriot Homecare office on Sept. 14, reports WBIR-TV. The agency provides largely private duty care, but is reimbursed by Medicaid, Medicare, Veterans Affairs, and other payers, it indicates on its website.

There were six vehicles with at least six “responders” at the agency wearing gloves, moving in and out of the building, reports WVLT News.

“Today, Federal agents were at our office as part of an ongoing investigation which is nearing an end,” Patriot confirmed on its Facebook page Wednesday evening. “We do not anticipate another event at our business such as the one that occurred today,” the agency said.

“All employees are to resume the work needed to care for our patients with no interruption,” Patriot added. “Our patient care has always been and will continue to be our top priority. Service to our patients and employees has not and will not be affected in any way.”

Patriot had not responded to a HCW by AAPC request for comment at press time.

Other recent fraud and abuse developments include:

In Massachusetts: Arbor Homecare Services LPN Winnie Waruru has pleaded guilty to fraud charges in federal court, the Department of Justice says in a release. Chelmsford-based Arbor billed MassHealth for services that were never rendered, were medically unnecessary, or weren’t authorized; developed employment relationships as a way to pay kickbacks for patient referrals; and entered into sham employment relationships with patients’ family members, according to the DOJ. “Waruru was personally responsible for causing Arbor to bill MassHealth for over $1.2 million in skilled nursing visits, much of which was fraudulent,” the release adds. Waruru also passed cash payments allegedly from Arbor part-owner Faith Newton to two Arbor patients to retain those patients. Newton has pleaded not guilty and awaits trial. Waruru is scheduled for sentencing in January 2023.

In Colorado: After it self-disclosed conduct to the HHS Office of Inspector General, Elevation Hospice of Colorado agreed to pay about $150,000 for allegedly submitting claims for services provided by two unlicensed individuals, the OIG reports on its civil monetary penalties webpage.

In New Hampshire: After it self-disclosed conduct to the OIG, Home Healthcare, Hospice and Community Services Inc. agreed to pay nearly $27,500 for employing an individual that it knew or should have known was excluded from participation in Federal health care programs, the OIG reports on its CMPs webpage.

In Minnesota: And after another self-disclosure to the OIG, Comfort Home Health Care Group Inc. d/b/a Comfort Health agreed to pay nearly $16,500 for allegedly submitting claims for services provided by an unlicensed individual, according to the OIG CMPs webpage.