Home Health & Hospice Week

Recent reports focus on state survey issues.

The feds are keeping the pressure on home health, judging from the HHS Office of Inspector’s latest Semiannual Report to Congress. In the report, the OIG furnishes a laundry list of fraud cases in Medicare Fraud Strike Force cities of Miami and Detroit.

For example: The watchdog agency cited the case of father and daughter Abdul Malik Al- Jumail and Jamella Al-Jumail, who were sentenced to 10 and four years in prison, respectively, for Medicare home health fraud earlier this year (see Eli’s HCW, Vol. XXIV, No. 16). The HHA owners

“paid kickbacks and bribes to recruiters and others for beneficiary information that would be used to falsely bill Medicare millions for home health services that were medically unnecessary and not performed,” the OIG notes in the report. “The conspirators fabricated patient files and medical documents to give the false impression that medical services billed to Medicare were legitimate. After learning of her father’s arrest, Jamella directed and participated in the burning of patient charts and records to cover her false billings to Medicare.”

A co-owner, Firas Alky, was indicted in September 2012, but investigators believe that he fled the country. Alky is one of OIG’s Most Wanted Fugitives, the agency points out. The three other home health fraud cases the OIG highlights involve patient recruiters, kickbacks and false claims.

The OIG also reviews its series of reports that found unsatisfactory results of state surveys and related matters in New Jersey, New York, and Puerto Rico. And it cites its report about home health background checks (see Eli’s HCW, Vol. XXIV, No. 19).

The report’s focus on hospice was minimal compared to some years, referencing state-based reports similar to those conducted for HHAs.

Resource: See the report at http://oig.hhs.gov/reports-and-publications/archives/semiannual/2015/sar-fall15.pdf.