Home Health & Hospice Week

Fraud & Abuse:

OIG HHA Fraud Factors

Do you fall into the HHS Office of Inspector General’s high-risk profile for fraud? These five factors single you out, according to a report cited in the OIG’s new 2017 Work Plan:

  • episodes for which the beneficiary had no recent visits with the supervising physician;
  • episodes that were not preceded by a hospital or nursing home stay;
  • episodes with a primary diagnosis of diabetes or hypertension;
  • beneficiaries with claims from multiple HHAs; and
  • beneficiaries with multiple home health readmissions in a short period of time.

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