Home Health Nurse Pleads Guilty To $100M Fraud And Kickback Scheme

A home health nurse has pleaded guilty, in federal court in Boston, in relation to a $100 million home health care kickback scheme. Last week, Winnie Waruru pleaded guilty to one count of conspiracy to commit health care fraud; one count of health care fraud; one count of conspiracy to pay and receive kickbacks; two […]

Why OIG Telehealth Fraud Findings May Mean Further Roadblocks For Home Health

A number of health care providers that billed Medicare for telehealth services likely did so in a fraudulent or wasteful manner, according to federal watchdogs. That finding and others like it dampen the chances of home health providers being able to bill for virtual care moving forward. That’s one major takeaway from a recent report […]

Home Health Sector Remains Area of Focus For Fraud Watchdogs

The federal government saw a return of nearly $1.9 billion in health care fraud settlements and judgments in 2021. Of this $1.9 billion, the Medicare Trust Funds received $1.2 billion, and the U.S. Centers for Medicare & Medicaid Services (CMS) received roughly $98.7 million. The Health & Human Services Office of Inspector General’s (HHS-OIG) annual […]

Compassionate Homecare to Pay $6.53M to Resolve Allegations; OIG Releases Medicaid Fraud Report

Compassionate Homecare Inc., has agreed to pay $6.53 million to MassHealth in order to resolve allegations of unauthorized billing for services. The settlement irons out a 2018 lawsuit filed by the Attorney General’s office against Compassionate. The state’s lawsuit alleges that the company stole millions of dollars from MassHealth. Aside from the $6.53 million settlement, […]

DOJ Highlights Multiple Home Health-Related Fraud Cases in July

Home health enforcement efforts have been on the rise in 2021, especially over the past couple of months. There have been developments with at least two multi-million-dollar fraud schemes, with the watchdog arm of the U.S. Department of Health and Human Services (HHS) also releasing findings from a large hospice-related audit. On July 15, federal […]

OIG Ramps Up Home Health Oversight

When a public health emergency was declared last March, the Centers for Medicare & Medicaid Services (CMS) issued a variety of waivers allowing home health providers to more easily provide telehealth services during the crisis. Now, the Office of Inspector General (OIG) has announced an audit, dubbed the “HHA Telehealth Project,” that will examine home […]

COVID-19 Funding Presents an ‘Enforcement Perfect Storm’ for Home Health Providers, Others

The federal government saw $2.2 billion in civil fraud recoveries in 2020. Roughly 82% of those settlements and judgments — about $1.8 billion — were from matters related to the health care sector. That’s according to a recent report from Nashville, Tennessee-based law firm Bass, Berry & Sims. The report examined significant health care fraud […]

Massachusetts Home Health Agency Settles Improper Billing Allegations for $10M

Over the past few weeks, government officials have seemingly restarted their aggressive oversight of Medicare-certified home health agencies. For much of 2020, government watchdogs took a measured approach to health care oversight and enforcement, allowing operators to focus their efforts on COVID-19 mitigation instead of paperwork and compliance. But multiple settlements and charges have been […]

Home Health Agency, Former Executives to Pay $5.8M to Settle False Claims Act Allegations

Doctor’s Choice Home Care Inc. and two former executives have agreed to pay $5.15 million to resolve allegations that the home health agency provided “improper financial inducements” to referring physicians through “sham medical director agreements,” the U.S. Department of Justice (DOJ) announced earlier this month. DOJ had also alleged that the agency offered bonuses to […]