Medicare Compliance & Reimbursement

Number of HHA subjects investigated skyrocketed 125 percent in five years.

Federal investigators are using statistics like these from a new Government Accountability Office report when deciding where to focus their scrutiny:

Of the criminal cases pursued by 10 Medicaid Fraud Control Units, home health care providers comprised nearly 40 percent of criminal convictions and 45 percent of subjects sentenced in 2010.

Federal criminal cases focused on 639 home health agency subjects in 2010. The only two provider categories higher than that were 1,275 from durable medical equipment suppliers and 1,908 from medical practices, medical centers and clinics.

The number of home health agency subjects in criminal cases increased 125 percent, from 284 to 639, from 2005 to 2010.

In 2010, cases involving home care providers had the third-highest number of civil judgments and settlements.

Source: "Health Care Fraud: Types of Providers Involved in Medicare, Medicaid, and the Children's Health Insurance Program Cases (GAO-12-820), www.gao.gov/products/GAO-12-820.