Home Health & Hospice Week
Whistleblower Charges Focus On Face-To-Face
A $2.5 million settlement of whistleblower charges centers on face-to-face physician encounters for home health payments. Louisiana-based home health companies Health Care Options Inc. and Health Care Options of Lafayette Inc.; Texas-based Home Care Options Houston Inc.; and Howard D. Austin have agreed to pay to settle charges that they “defrauded the Medicare and Louisiana Medicaid programs by submitting false and fraudulent claims for payment for home health services without required face-to-face encounters between patients and physicians,” the Department of Justice says in a release. Options then-Director of Nursing Melanie Berzas filed the qui tam suit in 2014, according to the complaint. In addition to the F2F charges mentioned in the DOJ release, Berzas also accused Options of “deliberately ignoring clinical and documentation requirements” for recertifications, and “upcoding hypertension codes” to increase revenue. Berzas filed suit after Options CEO Annette Austin “completely” ignored her reports of the billing and documentation inadequacies, the 2014 complaint says.
Home Health & Hospice Week
- PDGM:
CMS Relents On 1 Group Of Diagnosis Codes For PDGM
Warning: Medicare will be watching how you use the newly included dysphagia codes. If you’ve [...] - Reimbursement:
These 6 R-Codes Will Increase Your PDGM Payment
Unspecified dysphagia is included. The codes the Centers for Medicare & Medicaid Services has agreed [...] - Diagnosis Coding:
Figure Out Your Alternatives For Top Diagnosis Codes
CMS won’t budge on excluding muscle weakness. While Medicare officials made some tweaks to PDGM’s [...] - Strategy:
Use These Last Weeks To Prep For Major Coding Changes
Check your progress on codes that will RTP. On Jan. 1, you need to hit [...] - Hospice:
Enforcement Vise Continues To Tighten On Hospice Industry
GAO wants more quality considerations injected into survey process. Hospice surveys are under fire again, [...] - Fraud & Abuse:
Will Your Own Data Land You In Hot Water?
Brace for more audits, among other fraud-fighting measures. Here’s what you can expect to see [...] - Surveys & Certification:
Alternative Sanctions May Be On The Horizon For Hospices
Can you afford a $20,000 per day fine? The HHS Office of Inspector General and the [...] - Industry Note:
OIG Eyes Hospital Proration Policy That Affects Referrals
Findings from a recent OIG audit may make your hospital referrals more elusive than ever. [...] - Industry Note:
PDGM Manual Changes Are Out
See new Medicare Claims Processing Manual changes to accommodate PDGM at - Industry Note:
Whistleblower Charges Focus On Face-To-Face
A $2.5 million settlement of whistleblower charges centers on face-to-face physician encounters for home health [...] - Industry Note:
LHC-LifePoint To Make 3 Buys
LHC Group Inc. and LifePoint Health are continuing to expand their existing joint venture partnership, [...]
