Home Health & Hospice Week

Report revisits $3.1 million hospice settlement.

Home health agencies are front and center when it comes to targets on which the feds are focusing. So says the HHS Office of Inspector General in its semiannual report to Congress. The OIG is “tracking its own performance in priority areas, such as … reducing improper payments for home health services in fraud ‘hot spots,’” according to the report that summarizes the OIG’s activities for the six months ending March 31.

Key areas for enforcement included “fraud in non-institutional settings, including in Medicare home health services and HCBS, including personal care services (PCS),” the report adds.

The OIG highlights some high profile Health Care Fraud Strike Force home health cases, including one in the Detroit area. Zafar Mehmood and Badar Ahmadani were convicted last year of obtaining patients by paying cash kickbacks to recruiters, who in turn paid cash to patients to induce them to sign up for home care with Mehmood’s companies: Access Care Home Care Inc., Patient Care Home Care Inc., Hands On Healing Home Care Inc. and All State Home Care Inc. The defendants also paid kickbacks to physicians to refer patients to the defendants’ companies for unnecessary home care services (see Eli’s HCW, Vol. XXV, No. 42). Mehmood was sentenced to 30 years in prison and $40.4 million in restitution and Ahmadani was sentenced to eight years in prison and $38.1 million in restitution, the report notes.

Another one: The OIG also offers the case of Christian Home Health Care Inc. owner Elaine Davis and physician Pramela Ganji. Davis was convicted last year of paying employees to recruit new patients, and Ganji was convicted of furnishing bogus certifications for the patients whom she often had never seen (see Eli’s HCW, Vol. XXV, No. 16).

Davis was sentenced to eight years in prison while Ganji was sentenced to six years, and they were ordered to pay a combined $9 million in restitution, the report says.

The OIG also reviews a case in Detroit involving kickbacks and medically unnecessary services for home health and hospice patients, and a case in Houston. In the Houston case, Oakey Chikere, the owner and operator of Direct Care medical clinic, solicited kickbacks from HHAs for referrals for patients bogusly certified for home care and hospice services, the OIG report says. Chikere was sentenced to five years and 10 months in prison and $258,738 in restitution.

The OIG also reiterates its $3.1 million settlement with Kindred Healthcare for failing to comply with its Corporate Integrity Agreement regarding hospice services (see Eli’s HCW, Vol. XXV, No. 35). Kindred acquired the CIA with its 2014 acquisition of Gentiva. Gentiva, in turn, had inherited the billing problems causing the settlement from its $1 billion acquisition of hospice chain Odyssey in 2010.

Note: See the report at https://oig.hhs.gov/reports-and-publications/archives/semiannual/2017/sar-spring-2017.pdf.