Home Health & Hospice Week
Data Mining Leads To Hospice Fraud Settlement
Owners excluded from Medicare for 7 years. If your billing is outside the norm, you'd better make sure you can back it up. Two former hospice owners have learned that lesson the hard way. Hospice Family Care Inc. in Phoenix has agreed to pay $3.7 million to resolve allegations that it "submitted claims for payment to Medicare for patients who were either completely or partially hospice ineligible or were provided a higher level of hospice care than was necessary or allowable," according to a release from Arizona U.S. Attorney Ann Birmingham Scheel. And former Hospice Family Care owners Nancy Smith and Nancy Turner agreed to be excluded from Medi-care, Medicaid, and all other federal health care programs for seven years. "Our agents used sophisticated data analysis techniques to investigate Hospice Family Care's activities," Glenn Ferry, Special Agent in Charge of the HHS Office of Inspector General region covering Arizona, says in the release. "Health providers planning to submit false claims to government programs are warned that investigators will be using these data mining tools alongside traditional techniques to root out fraud." One day after the feds announced the settlement, Smith and Turner closed on a deal to sell the hospice to an undisclosed buyer, reports the Phoenix Business Journal. "Believe me, if my clients weren't in the process of selling this company, we would have fought this to the bitter end," the company's attorney, Frederick Petti, told the newspaper. "We would have prevailed. This is a business decision.
Home Health & Hospice Week
- Reimbursement:
Providers Wrestle With Common Working File Mistakes
CMS claims its hands are tied when it comes to inaccuracies in the Common Working [...] - Hospice:
Get A Glimpse Of Your Hospice Quality Reporting Future
You might want to work on your pain management strategies first.Required quality reporting for hospices [...] - Regulations:
New HHCAHPS Data Wave Coming In July
Plus: Medicare's hospice cap catch-up should end by next spring.If your CAHPS data didn't show [...] - Diagnosis Coding:
Get Your V Code Usage Straight
Warning: Don't confuse 'status' and 'attention to' V codes.Home health coders and V codes have [...] - Industry Note:
Data Mining Leads To Hospice Fraud Settlement
Owners excluded from Medicare for 7 years.If your billing is outside the norm, you'd better [...] - Industry Note:
Small Businesses Eschew Tax Credit, GAO Finds
If you're not using the Small Employer Health Insurance Tax Credit, you're not alone. When [...] - Industry Note:
Observe These New Rules For 5010 Claims
Don't let technical oversights lead to claims rejections when Medicare starts enforcing the 5010 claims [...] - Industry Note:
Prior Authorization Demo Slated For This Summer
Providers with patients who need power mobility devices are still waiting to hear when a [...] - Industry Note:
Refile RAPs For Claims Booted In Error For PECOS
If you had claims that received reason code 32072 before the PECOS edit was turned [...] - Industry Note:
Correct Hospice Election Errors The Right Way
Watch out for errors on your Notices of Election, or you'll have to jump through [...] - Industry Note:
CMS Gives Benchmark Data To Oxygen Billers
Providers who furnish home oxygen will get a chance to measure themselves against their peers [...] - Industry Note:
Virginia HHA Owner Indicted For Bogus Claims
A Medicaid home care agency owner in Virginia has been indicted for submitting claims for [...] - Reader Question:
Keep Physician Communication Open To Avoid Getting Stuck With The Bill
Make sure the ordering doc is on board with your care plan early on, experts [...]
