Home Health & Hospice Week

A potential crackdown on chronic care management service payments to physicians could have a chilling effect on home care referrals.

An HHS Office of Inspector General audit found $436,877 in overpayments in 2015 and 2016 for instances in which providers or facilities billed CCM services more than once for the same benefi­ciaries for the same service period, according to a new report on the topic. OIG auditors also found $203,575 in overpayments for instances in which the same physician billed for both CCM services and overlapping care management services for the same beneficiaries. Patients were charged more than $173,000 for their part of the invalid services.

Further, the OIG identified 37,124 claims totaling $1.2 million in potential overpayments for instances in which a CCM service was billed by an outpatient facility but a corresponding claim was not submitted by a physician. Those claims need further review for verification, the OIG says.

The report is at https://oig.hhs.gov/oas/reports/region7/71705101.asp.