Home Health & Hospice Week
Texas HHA Biller Faces False Claims Charges
It’s not just the boss who goes to jail for Medicare fraud.
Case in point: A former biller for Sambritt home health agency in Weslaco, Texas has been charged with Medicare fraud. Natalie Martinez participated in a health care fraud conspiracy that involved false claims from July 2011 to November 2012, according to She was also charged with filing a false statement to the government, reports The Monitor newspaper.
Prosecutors say the conspiracy involved forged doctor signatures, referrals in exchange for kickbacks, excessive services, and misrepresenting patients’ medical conditions to bill more, according to the newspaper. Sambritt’s owners “would and did send their employees to doctors’ offices to induce office staff to refer patients to Sambritt by giving unlawful kickbacks” that included lunch, gifts and gift cards, court records state. The kickbacks were used to sign up more people “regardless of whether the Medicare beneficiary needed home health care services.”
Sambritt president Yolanda Cabera has not been charged — yet, The Monitor notes. The feds seized more than $77,000 from a Sambritt bank account owned by Cabera last September.
Home Health & Hospice Week
- Face-To-Face:
Employ These 6 Strategies To Prevent F2F Meltdown
Guarantee: New contractor will review your face-to-face physician encounter documentation. Despite an OIG report that [...] - Compliance:
Build A Better F2F Form With These Tips
Will checkboxes help or hinder your face-to-face compliance? Your path to optimal face-to-face compliance may [...] - Documentation:
Provide These Narrative Examples To Your Physicians To Improve F2F Compliance
Three sentences is all it takes to get into compliance — but they must be [...] - Reader Question:
Handle Existing Meds This Way On Hospice Claims
MACs answer agencies’ questions about drug reporting in newly expanded Q&As. Reader Question: What do [...] - Fraud & Abuse:
Whistleblowers Net $26 Million From Amedisys Settlement
Government finalizes $150 million fraud settlement and releases surprising details. The $150 million settlement of [...] - Industry Notes:
Ease Your PECOS Edit Appeals Burden With Reopenings
Tip: Don’t bother filing a reopening if your doc isn’t yet in PECOS. If you’re [...] - Industry Notes:
Lack Of OASIS Support #1 Denial Reason
Lack of documentation for OASIS M0 items edged out face-to-face as the chief reason for [...] - Industry Notes:
Study: Med Management Helps Some Patients Avoid Hospital
Your lowest risk patients may benefit from medication management to reduce rehospitalizations, but it probably [...] - Industry Notes:
MAC Gets Ready To Recoup FISS Glitch Overpayments
If you received an overpayment related to sequestration, it’ll soon be time to pay it [...] - Industry Notes:
Hospital Agencies Merge With Competitors
Market consolidation continues. In Dan-ville, Pa., Geisinger Community Health Services and SUN Home Health & [...] - Industry Notes:
Okla. Hospice Owner, Manager Charged With Medicare Fraud
Allegedly lying in an audit has landed a hospice owner and general manager on the [...] - Industry Notes:
Texas HHA Biller Faces False Claims Charges
It’s not just the boss who goes to jail for Medicare fraud. Case in point: [...]
