Home Health & Hospice Week
OIG Highlights Medicaid, Physician-Centered Home Health Cases
Medicaid agency settles fraud charges for $3.3 million. The HHS Office of Inspector General may have gone a bit light on the home care industry in its latest semiannual report to Congress, but home health agencies didn’t escape mention altogether. The OIG shines a spotlight on two home care-related cases. Case #1: Hope In-Home Care in Virginia agreed to pay $3.3 million to settle charges that, from January 2011 to September 2013, it employed and submitted claims to Medicaid for uncertified personal care aides who were ineligible to provide services; falsified documents and statements to qualify ineligible beneficiaries for services; made false statements in prior authorization requests for nonreimbursable respite services; engaged in “phantom billing” by billing for services not performed; and hired family members of Medicaid beneficiaries as personal care aides and submitted ineligible claims for care provided by them. Case #2: In New York, a group of Health Quest physician practices and a related facility agreed to pay $15.6 million and enter into a Corporate Integrity Agreement for a variety of misdeeds, including billing for “home health services that lacked sufficient medical records to support the claim, including documentation of a face-to-face encounter with a physician,” according to the report online at https://oig.hhs.gov/reports-and-publications/archives/semiannual/2018/2018-fall-sar.pdf.
Home Health & Hospice Week
- Targeted Probe and Educate:
About Half Of HHAs Flunk Palmetto TPE Review
Major discrepancy between MACs shows in results. If you consider a 50 percent failure rate [...] - Medical Review:
Big Chunk Of TPE Denial Reasons Still A Mystery
Are you taking these 4 steps before submitting every claim? No matter which HHH Medicare [...] - Reimbursement:
Are Latest Payment Error Numbers Delaying RCD?
Home health errors account for 10% of overall Medicare improper pay rate. Dec. 10 came [...] - Hospice:
Hospice Payment Error Rate Dips
Bad news: Hospices had the highest rate of erroneous claims. The heavy hand that the [...] - Regulations:
See Where Your State Falls On Improper Payment Rate Spectrum
High claims volume doesn’t necessarily translate to high error rates. Wondering where the feds might [...] - Fraud & Abuse:
OIG Doubles Down On Hospice Crackdown
Plus: Senior Medicare Patrol investigation leads to $2 million hospice settlement. Home health agencies are [...] - Industry Note:
OIG Highlights Medicaid, Physician-Centered Home Health Cases
Medicaid agency settles fraud charges for $3.3 million. The HHS Office of Inspector General may [...] - Industry Note:
Rate Of Spending Growth Down 1%
Health care spending continues its slow and steady growth. “Overall national health spending grew at [...] - Industry Note:
Take A Look At Your Next Hospice Compare Data
Don’t miss your chance for a sneak preview of your Hospice Compare data. Hospice provider [...] - Industry Note:
Therapy Caps Transition To Therapy Thresholds
Home care providers that also furnish Part B outpatient therapy in the home should take [...] - Industry Note:
That U5181 Return You Think Is An Error May Be Legit
Beware an ongoing payment system glitch that could be hanging up your hospice claims — [...] - Industry Note:
Alaskan Providers Can Use Offered Regulatory Relief
Check out regulatory flexibility offered to providers affected by the Alaskan earthquake at www.cms.gov/Emergency. HHS [...] - Industry Note:
Tap This Updated HIPAA Education Tool
Find out more about HIPAA with the Centers for Medicare & Medicaid Services’ newly updated [...] - Industry Note:
Massage Therapist, HHA Owner Plead Guilty
A Miami home health agency owner and a massage therapist masquerading as a physical therapist [...]
