CNBC: Home Health Care Likely Target in Fraud Schemes

Conservative estimates place U.S. annual health care fraud in the range of $80 billion, and “the battle is never ending,” a recent CNBC article reports.

One form of fraud on the list: billing Medicare for home health care that is never provided. Citing the recent home health care fraud scheme conducted by Dallas-based Dr. Jacques Roy totaling nearly $375 million, CNBC looks into the potential for fraud in the home health industry. CNBC reports:

In a report to Congress in March, the Medicare Payment Advisory Commission said high payments in the home health care arena “may also encourage the entry of marginal or fraudulent providers who are disproportionately motivated by the financial returns offered by excessive payments.”

In February, authorities uncovered what they say is the largest health care fraud scheme in U.S. history, according to Deputy Attorney General James Cole. Dr. Jacques Roy and six others in association with Medistat Group Associates were arrested in Dallas on charges of participating in a nearly $375 million health care fraud scheme.

“Between January 2006 and November 2011, Medistat certified more Medicare beneficiaries for home health services and had more patients than any other medical practice in the United States,” according to the indictment.

…“These fraudsters are taking advantage of lists that they are either buying on the Internet or trading in local markets, and just billing for claims that were never provided, operating a false front operation and getting out and moving on as quickly as possible,” Gary Cantrell, inspector general for investigations at Health and Human Services told CNBC.”

Read the original article.

Written by Elizabeth Ecker

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Elizabeth Ecker
Director of Content at Home Health Care News
Curious about all things, when not writing about senior housing topics, Liz is an avid explorer of food. She loves trying new recipes, new restaurants and new ice cream flavors. (Current favorite: Goat cheese with red cherries.)



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