Home Health & Hospice Week
Semiannual Report Profiles HH Fraud Cases
The HHS Office of Inspector General lists a few significant home health fraud cases in its Fall Semiannual Report to Congress. Case #1: The two co-owners of Fifth Avenue Home Health in Los Angeles pleaded guilty to billing for unnecessary home health services. Angela Avetisyan and Ashot Minasyan were sentenced to more than 16 years in prison and ordered to pay $4.2 million in restitution. The case involved kickbacks, patient recruiters, and a referring physician billing for unnecessary services of his own. Case #2: The OIG also rehashes the case of patient recruiter Egondu “Kate” Koko in Houston. Koko was sentenced to more than 15 years in prison after pleading guilty to being a patient recruiter for four Houston HHAs, as well as the owner and operator of Circuit Wide Home Health Services there. Koko also admitted to paying illegal kickbacks and bribes to physicians and patients, to laundering money with the help of a Nigerian national, and to buying a home with fraud proceeds (see Eli’s HCW, Vol. XXVIII, No. 20). The report also mentions the OIG’s earlier report on using Comprehensive Error Rate Testing results to target “high-risk” HHAs for fraud review (see Eli’s HCW, Vol. XXVIII, No. 32). The report is at https://go.usa.gov/xpPrm.
Home Health & Hospice Week
- Review Choice Demonstration:
Take These 7 Crucial Steps To Prepare For RCD
Hint: RCD readiness will help with PDGM. With the Patient-Driven Groupings Model taking effect in [...] - Patient-Driven Groupings Model:
Be Aware Of These Clinical Group Code Changes
Final rule contains some last-minute reshuffling. The addition of dysphagia codes isn’t the only diagnosis [...] - Diagnosis Coding:
Proposals To Include Diagnosis Codes In PDGM Get A Big 'No'
CMS rebuffs suggestions to add codes to higher-paying MS Rehab, Wound clinical groups. If you [...] - Hospice:
OIG: 55% Of Cases Reviewed Lacked Aide Supervisory Visits
Watch out: Tougher enforcement is ahead. The old adage “if it’s not documented, it’s not [...] - Surveys & Certification:
Follow 9 Tips To Boost Aide Supervisory Visit Compliance
Make sure your RNs document visits the right way. With the OIG throwing its spotlight [...] - Compliance:
Where Do Checkboxes Fit In To Supervisory Visit Records?
Tip: A single checkmark won’t do the job. How extensive your aide supervisory visit documentation [...] - Industry Note:
Check Out These New PDGM Documents
Education article for referring physicians explains their diagnosis coding duties. With the Patient-Driven Groupings Model [...] - Industry Note:
Semiannual Report Profiles HH Fraud Cases
The HHS Office of Inspector General lists a few significant home health fraud cases in [...] - Industry Note:
Sign Up For iQIES Or Miss Payments
CMS and its contractors are pulling out all the stops to get home health agencies [...] - Industry Note:
MBI Usage Gets Closer To 90%
PDGM isn’t the only change coming Jan. 1. You have only a few weeks until [...] - Industry Note:
LHC Partnership Buys Texas Provider
An LHC Group partnership with Texas Health Resources and Methodist Health System, DFW Home Health, [...] - Industry Note:
Texas Hospital To Sell Home Care, Hospice
Graham Regional Medical Center in Graham, Texas, has gotten approval to accept an undisclosed offer [...]
