Editor’s Picks: Tall Tales and Fraud in Home Health

This week, Home Health Care News readers heard from frustrated home health agencies in Illinois after the Centers for Medicare & Medicaid Services (CMS) released data that characterized the Pre-Claim Demonstration as proceeding smoothly there.

Readers also learned the fate of the former vice president at Amedisys Inc. (Nasdaq: AMED) who stole $7.6 million from the company, and learned why several home health care organizations and associations think CMS should postpone implementing mandatory bundled payments for conditions other than joint replacements.

Most Read

Agencies Slam ‘Misleading’ Data on Illinois Pre-Claim—Though providers in Illinois have been reporting numerous issues and sky-high non-affirmation rates for claims submitted under the Pre-Claim Review Demonstration, CMS recently released data that seems to characterize the program as proceeding smoothly. In fact, the data seem so optimistic, it’s difficult for many to believe it tells the whole story of how the demonstration is rolling out in the Prairie State, and others have deemed it flat out “misleading.”

Former Exec Must Repay $7.6 Million Stolen From Amedisys—A former vice president with Baton Rouge, Louisiana-based Amedisys Inc., Michael David Pitts, has been sentenced for stealing more than $7.6 million from the company, which provides home health care to approximately 380,000 people in 36 states.

Kindred, NAHC Say to Hit the Brakes on Bundled Payments—CMS should take more time to evaluate the Comprehensive Care for Joint Replacement (CJR) demonstration before implementing mandatory bundled payments for other conditions, according to public comments on the July proposed rule that were submitted by several organizations, including Kindred Healthcare (NYSE: KND), the National Association for Home Care & Hospice (NAHC) and the Alliance for Home Health Quality & Innovation (AHHQI).

Weekend Reads

‘Let Us Give Our Families the Care We Give Your Families’— The Atlantic interviewed Vickie Miller, a home-care worker from Greenville, South Carolina, who’s also a member of the Fight for $15 movement. In the interview, Miller discusses how she copes with her job’s lack of benefits, her relationship with the people she cares for and how America is dealing with its aging population.

Grandson Orders Pizza for Grandma to Check That She is OK After Hurricane Matthew—A man in Omaha, Nebraska, sent a pepperoni pizza to his 87-year-old grandmother in Palm Coast, Florida, so the delivery man could check on her after Hurricane Matthew, the New York Daily News reported. The grandma, Claire Olsen, reported that the pizza was “fantastic” and said she called all her family members as soon as her phone began working again.

Written by Mary Kate Nelson