Home Health & Hospice Week

Bad actors may circumvent enforcement through unrevealed business associations.

The feds might begin looking more closely at your business relationships, thanks to a new report from the HHS Office of Inspector General.

OIG investigators looked at 10 Texas durable medical equipment suppliers that had $7.3 million in "currently not collectible" overpayments to Medicare. Six of those 10 suppliers had associations with other suppliers or home health agencies that received $58 million in Medicare payments from 2002 to 2007, according to the report (OEI-06-07-00080).

Most of the suppliers were connected to other businesses through shared owners and managers, including family members, the OIG notes. Some also shared addresses and telephone numbers.

Enrollment applications for the suppliers and agencies investigated didn't always include the names of all owners and managers. "These results suggest that individuals associated with Medicare debt could inappropriately receive Medicare payments by omitting owner/manager information on their enrollment application and working through other DMEPOS suppliers and HHAs," the OIG warns in the report.

Often, suppliers associated with other in-debt suppliers already had billing privileges revoked or were otherwise under investigation, the OIG notes. But that wasn't the case for affiliated HHAs. "These results indicate that the associations between DMEPOS suppliers and HHAs may be less frequently detected than those between DMEPOS suppliers alone," the report cautions. v