The Office of the Inspector General (OIG) is making good on its long-held promise to ramp up oversight of home- and community-based services, requesting an extra $10 million in its fiscal year 2020 budget to tackle fraud, waste and abuse in those areas. The extra funding — which would increase this portion of OIG’s budget […]
Category: Fraud
If you operate a home health agency, Laura Long and her colleagues are probably the last people you want to hear from. Long is the Medicare operations lead at AdvanceMed, one of five unified program integrity contractors (UPICs) nationwide hired by the Centers for Medicare & Medicaid Services (CMS) to audit and investigation home health […]
Federal authorities took action against a handful of individuals and companies last month for their roles in multimillion-dollar home health fraud schemes. On Feb. 15, a Michigan woman pleaded guilty for her role as a patient recruiter in a scheme involving about $1.2 million in fraudulent Medicare claims for home health care procured through kickback […]
The U.S. Department of Justice (DOJ) made nearly half a dozen announcements at the end of January regarding Medicare fraud involving home health agencies. Among them: A Miami woman was sentenced to more than four years in prison on Jan. 17 for her role in a $4.66 million health care fraud scheme involving several Florida-based […]
A subsidiary of one of the nation’s largest hospice companies — Curo Health Services — has agreed to pay millions of dollars to settle a federal whistleblower lawsuit claiming that the company submitted Medicare claims that were medically unnecessary or lacked documentation. Curo Health Services was acquired by Humana Inc. (NYSE: HUM) and private equity […]
For years, the Department of Health and Human Services Office of Inspector General (OIG) has been ramping up efforts to battle Medicare fraud — including in home health and hospice. Now, a new OIG semiannual report is showing the agency’s progress, to the tune of $2.91 billion in expected investigative recoveries for fiscal year 2018. […]
A group of home health aides will receive a $4 million settlement to resolve a suit that claims they weren’t paid all the wages a New York company owed them. After granting preliminary approval in June, a U.S. District judge granted final approval to the class and collective settlement Tuesday. In 2016, plaintiff Allison Hypolite […]
Two sisters and 10 of their employees have been indicted after a federal grand jury said they spent years using their home health care companies to defraud the Pennsylvania Medicaid program. Home health care companies owned and operated by sisters Arlinda Moriarty and Daynelle Dickens received more than $87 million in Medicaid payments for services […]
The Medicare fee-for-service improper payment rate in 2018 is the lowest it has been since 2010. A sharp drop in home health improper payments, in particular, is a big part of the reason why. Improper payments decreased by roughly $4.59 billion from 2017 to 2018, according to the U.S. Centers for Medicare & Medicaid Services […]
Federal investigators had a busy month of October shining a light on major fraud schemes throughout the home health industry — and November appears to be more of the same. A federal jury on Friday found a patient recruiter guilty for her role in a scheme involving roughly $1.1 million in fraudulent Medicare claims for […]