Home Health & Hospice Week
Kickback Schemes Lead To Guilty Plea, Conviction, Arrests
Therapy company staff fake notes, feds say. Illegal kickbacks are at the heart of three recent enforcement actions in two states. In Michigan: Ghalia Savaya has pleaded guilty in a Medicare home health fraud case, says the Department of Justice in a release. Savaya admitted that, from April 2015 to November 2017, she received illegal kickbacks in exchange for referring Medicare beneficiaries to home health agency Franklin Health Care in Troy. Medicare paid more than $1.25 million for claims related to beneficiaries referred by Savaya, which included claims for beneficiaries not eligible to receive home care services. Savaya is scheduled to face sentencing May 30. In Florida: After a four-day trial, patient recruiter Yamilet Diaz was convicted of kickback charges, the DOJ says in a release. Prosecutors showed that from October 2012 to June 2013, Diaz received at least $306,800 in kickbacks in return for referring Medicare beneficiaries to Good Friends Services Inc., a now-defunct HHA in Hialeah Gardens. Medicare paid more than $600,000 to Good Friends based on claims for home care services submitted on behalf of the beneficiaries recruited by Diaz, according to the Justice Department. Also in Florida: A Miami HHA owner and two others have been arrested for an alleged kickback scheme. An indictment charges that between August 2014 and August 2015, Nissi Home Health Services Inc. owner Jose Antonio Mesa Sixto paid kickbacks to Llunaisy Acanda and Ania Hans in exchange for patient referrals. The indictment further alleges that between April 2012 and June 2015, Acanda, Hans, and others falsely certified therapy notes indicating that they provided therapy services to Medicare beneficiaries on behalf of Nissi through their companies, A&A Professional Therapy, St. Judges Staffing Group Inc., and Krystal Rehabilitation Services Corp., the DOJ says. Mesa Sixto is also charged with witness tampering.
Home Health & Hospice Week
- Reimbursement:
'Enhanced Oversight' For All New HHAs Means No RAPs — At Least For A While
Do feds see RAPs as free loans? A new RAP suppression instruction shows why home [...] - Billing:
Here's How RAP Suppression Will Work
HHAs must continue to submit RAPs, despite receiving no reimbursement for them. Medicare has laid [...] - Fraud & Abuse:
Kickback Schemes Lead To Guilty Plea, Conviction, Arrests
Therapy company staff fake notes, feds say. Illegal kickbacks are at the heart of three [...] - HIPAA:
No BAA Means No Business With That Vendor — Every Time
Failing to vet a vendor could cost you big. With so much on your plate, [...] - Industry Note:
Medicare Number Switch Gives Rise To Payment Glitch
MBI-HICN mismatch causes returned claims. Medicare has completed replacing beneficiaries old Health Insurance Claim Numbers, [...] - Industry Note:
CMS Issues Spending Projections
Spending on home care is projected to rise a whopping 83 percent from 2018 to [...] - Industry Note:
CAHPS Survey Mode Change Mulled
If you are frustrated by the difficulty of getting beneficiaries or their caregivers to respond [...] - Industry Note:
RHC Pay Problems Persist
Will the next Medicare claims system update finally clear up problems related to Routine Home [...] - Industry Note:
A/B Shift Error Requires Adjustments
Don’t let an administrative glitch confuse your billing efforts. The problem: The allocation of home [...] - Industry Note:
Don't Forget Digits
Make sure you’re inputting your county code correctly on your RAPs and final claims, or [...] - Industry Note:
Revisit Your Emergency Preparedness Plan
If the Zika virus, Ebola, and other types of infections aren’t covered in your Emergency [...] - Industry Note:
Know Your 'O's From Your Zeroes
Don’t forget that the new Medicare Beneficiary Identifiers do not contain “Os,” but instead utilize [...] - Industry Note:
Check The Newest Hospice Compare Data
Take a look at your most updated Hospice Compare data, which is now up on [...] - Industry Note:
HHQRP Training To Cover OASIS-D
Registration is still open for Medicare’s two-day Home Health Quality Reporting Training event in Baltimore [...] - Industry Note:
CMS Podcast Debuts
You can take a break from listening to Serial, Hidden Brain, and other popular podcasts [...] - Industry Note:
If The Holiday Rush Kept You From Tuning In
If the holiday rush kept you from tuning in to Medicare’s training webinar on hospice [...] - Industry Note:
Amedisys Grows Its Hospice Business — Again
Amedisys has agreed to purchase RoseRock Healthcare, a hospice in Tulsa, Oklahoma, the Baton Rouge, [...] - Industry Note:
Texas, Ohio Hospices Open Inpatient Units
The number of hospice inpatient facilities is increasing. In Texas: Hospice of Wichita Falls will [...]
