Referrals:
Beware Reliance On One Referral Source
Published on Fri Mar 16, 2012
Beefed up enforcement is your new reality. You may be thrilled to have one physician or practice that is a great referral source -- but that situation could land you under reviewers' microscope in the wake of the record-breaking fraud case against Dr. Jacques Roy and three Dallas home h alth agencies. The Centers for Medicare & Medicaid Services suspended Medicare payments for 78 HHAs in conjunction with the indictments against Roy and the HHAs Apple of Your Eye Healthcare Services Inc., Ultimate Care Home Health Services Inc., and Charry Home Care Services Inc. In a suspension letter obtained by Eli, CMS and its Zone 4 Zone Program Integrity Contractor Health Integrity tell agencies that "the average physician certifies no more than 5-10% of the plans of care (POCs) for a single home health agency's patient roster." Beware: CMS and the HHS Office Of Inspector General "are data mining to determine [...]