Home Health & Hospice Week

Jail time and fines for kickbacks, cost report fraud featured in semiannual roundup.

You'd better make sure you're toeing the compliance line - the HHS Office of Inspector General has got its eye on the home care industry, its latest semiannual report to Congress shows.

A group of Southern Florida HHAs made the OIG's compliance hit list in its roundup of enforcement activities for the six months ending in March 2005. Home Health Care Inc., Home Health Services of South Florida Inc. doing business as USA Home Health Inc., Medcare Home Health Service Inc., South Eastern Health Management Associates Inc. and their owner agreed to pay nearly $828,000 and enter a five-year corporate integrity agreement to settle allegations of cost report fraud from 1995 to 1997, the OIG says in the semiannual report.

"The government alleged that the HHAs billed Medicare for medically unnecessary home health visits and consulting services purportedly performed by a former owner, when in fact the former owner did not perform the services," the watchdog agency notes.

Also in the hot seat: A Florida franchise of Tender Loving Care Health Care Services Inc. accused of marketing kickbacks (see Eli's HCW, Vol. XIV, No. 12); four Texas residents accused of Medicare HHA fraud who were ordered to pay $2.9 million and serve up to 102 months of prison time; and a Wisconsin HHA administrator/director of nursing accused of Medicaid fraud related to false time sheets who agreed to a $40,000 civil settlement and a 10-year exclusion from federal health care programs.

The OIG also repeated its recommendation that the Centers for Medicare & Medicaid Services require physicians to examine a patient before ordering home care services for her. The OIG listed no enforcement action examples for hospices. 

Editor's Note: The report is online at www.oig.hhs.gov/publications/docs/semiannual/2005/OIG_semiannual1-2005.pdf.