Home Health & Hospice Week

"These six measures of questionable billing indicate potential fraud," the HHS Office of Inspector General warns in a new report. Here are the actual thresholds (in BOLD) that put agencies over the top in the OIG's view:1. High average outlier payment amount per beneficiary -- $403. Total outlier payments each HHA was paid in 2010 relative to the number of beneficiaries for whom the HHA billed Medicare in that year. "We also calculated each HHA's total outlier payments relative to total Medicare payments in 2010," the OIG explains. Number of HHAs exceeding the threshold: 1,684. Median among all HHAs: $13.2. High average number of visits per beneficiary -- 91. Total number of visits each HHA billed in 2010 relative to the number of beneficiaries for whom the HHA billed Medicare in 2010. Number of HHAs exceeding the threshold: 658. Median among all HHAs: 32.3. High percentage of beneficiaries for whom other HHAs [...]