Home Health & Hospice Week
Whistleblower Lawsuit Leads To Hospice GIP Settlement
Atlanta hospice forks over half-million dollars to lay fraud charges to rest. You'd better make sure your general inpatient hospice claims are well documented, because the government's campaign against fraudulent GIP billing continues. Case in point: AHH Historic Inc. hospice in Atlanta will pay $555,000 to settle charges that it upcoded GIP days, says the FBI in a release. The government alleges that AHH, formerly known as Altus Healthcare & Hospice Inc., submitted false claims to the Medicare and Medicaid programs for GIP care for patients who did not qualify to receive that level of hospice care from 2008 to 2011. The settlement is a result of a False Claims Act suit filed by whistleblower David C. Boal, who will receive part of the settlement. Boal is identified in a 2008 Gainesville Times news article as a hospice worker. "Altus Healthcare allegedly milked Medi-care's hospice benefit to increase their own profit as much as possible," Derrick Jackson, Special Agent in Charge of the HHS Office of Inspector General for the Atlanta region, says in the release. The OIG "is committed to eliminating this greed from our nation's health care system." Altus was acquired by Halcyon Healthcare in December 2011.
Home Health & Hospice Week
- Survey & Certification:
Surveyors Gain New Arsenal Of Tools In Proposed Rule
CMS gives HHAS a survey wakeup call with alternative sanctions.Are you ready to pay $10,000 [...] - Enforcement:
Check Out 5 New Alternative Sanctions
How long would you survive under a payment suspension?As always, the Medicare program will retain [...] - Regulations:
Surveyors To Use 6 Factors When Setting CMP Rates, Other Sanctions
Immediate jeopardy determination will make the biggest difference.How will a surveyor decide you just need [...] - Compliance:
Alternative Sanctions Come With A Silver Lining
Informal dispute resolution will give agencies a chance to point out surveyor mistakes.Medicare's newly proposed [...] - Industry Note:
Whistleblower Lawsuit Leads To Hospice GIP Settlement
Atlanta hospice forks over half-million dollars to lay fraud charges to rest.You'd better make sure [...] - Industry Note:
Your CAHPS Data Is Showing
Your Home Health CAHPS patient satisfaction data is now up on the Home Health Compare [...] - Industry Note:
Outlier Payments Still Aren't Fixed
You'll have to wait a while longer for your outlier reimbursement. The Centers for Medi-care [...] - Industry Note:
CMS To Base ACH Rate On Claims Data -- Not OASIS
Don't be surprised to see your acute care hospitalization (ACH) outcome data change. CMS plans [...] - Industry Note:
Use This Free Hospice Quality Reporting Training
Trying to get up to speed on the new hospice quality reporting requirements that kick [...] - Industry Note:
ACOs Continue To Expand
Still trying to figure out exactly what your role should be in Medicare's Accountable Care [...] - Industry Note:
Docs Face 27% Pay Cut
Expect your referring physicians to be scrambling as their 27 percent Medicare pay cut looms [...] - Industry Note:
CMS To Collect Data On Therapy Patient Function
Wondering how CMS may reconfigure the therapy portion of home health payment rates? Take a [...] - Industry Note:
NYC Aides Win OT Suit
The battle over the federal "companionship exemption" to overtime laws continues, but that may not [...] - Industry Note:
Detroit HHA Owners Face Kickback, Fraud Charges
Two more home health agency owners in Detroit are facing fraud charges. Usha and Dee-pak [...]
