Jury Convicts Duo In $93 Million Medicare Home Health Fraud Scam

A man and woman in Florida were convicted for their roles in a conspiracy to defraud Medicare by billing over $93 million for home health therapy services that were never provided. The conviction was brought down by a federal jury in Miami this week. The two people convicted — Karel Felipe and Tamara Quicutis — […]

Where, When And Why Home Health Billing Fraud Becomes Obvious

A new comprehensive study is shining a light on potential factors that have led to home health billing fraud over the years. Among other findings, researchers at Dartmouth’s Geisel School of Medicine concluded that home health agencies that share patients across multiple agencies, and those that had high rates of expenditures across hospital referral regions […]

Cyber Attacks Hurt Home Health Operations – But Patient Outcomes Are Next

For home-based care providers, cyber attacks are less likely to be an “if,” and more likely to be a “when.” And, as cyber attackers get more creative and persistent, it’s important for providers to understand the implications of attacks. “Over the last 18 months, we’re seeing massive impacts to patient care,” Fortified Health Security CEO […]

DOL Will Claw Back Nearly $10 Million From Direct Care Worker Staffing Agency

The U.S. Department of Labor (DOL) announced that it will recover $9.3 million in back wages and liquidated damages. The funds stem from a Philadelphia health care staffing company misclassifying 1,756 employees, including home health aides, and depriving them of overtime wages. A consent judgment in the U.S. District Court for the Eastern District of […]

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, […]