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 that were never […]
Category: Fraud
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 […]
It’s been a busy month so far for home health care and hospice fraud. On Thursday, the U.S. Department of Justice announced that two Detroit-area home health agency owners were sentenced to a combined 16 years of prison for their roles in a multimillion dollar scheme to defraud Medicare by billing for home health services […]
A former hospice owner has pleaded guilty to one count of conspiracy to commit health care fraud in a Greenville, Mississippi court. Charline Brandon of Cleveland, Mississippi, submitted nearly $11 million in fraudulent claims to Medicare and more than $2 million to Medicaid while running Cleveland-based Haven Hospice, North Haven Hospice, Lion Hospice and North […]
Democratic Rep. Peter Welch of Vermont on Tuesday unveiled bipartisan legislation to combat Medicaid fraud and abuse originating outside of institutional health care settings. The bill would build on the authority of state Medicaid Fraud Control Units (MFCUs) and expand the scope to encompass all Medicaid services including non-institutional settings, such as home health care. […]
A federal grand jury in San Jose indicted three doctors and three employees of Milpitas Home Health Agency for conspiracy to pay and receive kickbacks for referrals. U.S. Attorney Alex G. Tse and Federal Bureau of Investigation Special Agent in Charge John F. Bennett announced the medical professionals were charged at the end of August. According […]
Trends in hospice fraud have authorities on high alert and providers feeling the heat. But a looming, potentially precedent-setting legal case currently in the hands of the 11th Circuit Court of Appeals may soon make the prosecution of hospice providers much more difficult to pursue under the False Claims Act (FCA). “[The case] could decimate […]
In March 2018, Health and Palliative Services of the Treasure Coast and two of its businesses paid $2.5 million to settle a False Claims Act (FCA) case related to hospice billing. A month later, Horizons Hospice agreed to pay more than $1.2 million to resolve allegations that the company fraudulently billed Medicare and Medicaid for services to patients […]
A home health agency will be paid for services following a court win that prevents the Centers for Medicare & Medicaid Services (CMS) from withholding and recouping payments—at least temporarily. A judge granted the home health agency’s temporary restraining order motion in the case, Family Rehab., Inc. v. Azar, which will temporarily ensure payments are not […]