NY Times: Adult Day Centers Blur Medicaid Eligibility

In New York City, adult day care centers provide seniors with community-based services, while simultaneously blurring the line for Medicaid eligibility, according to a New York Times article. To receive the benefits of Medicaid, individuals must be impaired enough to require at least 120 days of help with activities such as walking, bathing and even getting […]

Ohio Man Pleads Guilty to $2.5 Million Home Health Fraud

A man from Orange, Ohio admitted to overfilling Medicaid and Medicare by more than $2.5 million, according to U.S. Attorney Steven M. Dettelbach from the Northern District of Ohio.  Divyesh “David” C. Patel, age 39, pleaded guilty to one count of conspiracy to commit health care fraud and four counts of health care fraud.  Patel […]

Home Healthcare Community Applauds Senate Committee for Medicare Reform Initative

The Partnership for Quality Home Healthcare (PQHH) commended members of the Senate Finance Committee for urging regulators to increase efforts to combat Medicare waste, fraud and abuse.  Senators Orrin Hatch (R-UT), Chuck Grassley (R-IA) and Tom Coburn (R-OK) are urging the Centers for Medicare and Medicaid Services (CMS) to implement a moratorium on the installment […]

Obama’s 2014 Budget May Spell Changes for Home Health Providers

The home health care industry could experience some changes in 2014 such as Medicare copayments for new beneficiaries or increased fraud prevention measures for agencies receiving federal reimbursements. Some aspects of President Obama’s 2013 budget pertaining to home health care will likely remain for next year’s budget, expected to be released on April 10, according […]

Louisiana Couple Convicted in $17 Million Home Health Fraud Scheme

The owner and director of nursing of a Louisiana home health agency were each convinced Friday for conspiring to defraud Medicare of $17.1 million, according to the Department of Justice (DOJ). Louis T. Age, 64, and Verna S. Age, 60, both of Slidell, La., were each convicted by a federal jury in the Middle District […]

13-Year Prison Sentence for Woman Involved in Medicare Fraud Scheme

A woman involved in an $8 million Medicare fraud scheme received a 156-month federal prison sentence, the Federal Bureau of Investigation announced. Uben Ogbu Rush, of Carson, Calif., was sentenced to 13 years in prison by a United States District Judge for her role in a fraud case where she illegally paid kickbacks for referrals […]

Virginia Home Health Owners Sentenced in $2.1 Million Fraud Scheme

The owners of a Virginia home health care agency were sentenced last week to 121 months in prison for their roles in a health care fraud scheme. From January 2008 through June 2011, Irvine Johnston King, 46, and Aisha Rashidatu King, 40, of Woodridge, submitted more than $2.1 million in false claims to Virginia Medicaid and Anthem […]

Hospice Company Agrees to $12 Million to Settle Medicare Fraud Case

Hospice of Arizona, L.C., its related entity American Hospice Management LLC, and their parent corporation American Hospice Management Holdings LLC have agreed to pay $12 million to settle allegations they violated the False Claims Act by submitting false reimbursement claims to Medicare for ineligible hospice services, the Department of Justice announced on Wednesday.  Between Sept. […]

Alabama Home Health Provider Agrees to Pay Fraud Settlement

Techota, LLC has agreed to pay $150,000 in a federal lawsuit that it violated the False Claims Act by fraudulently billing Medicare for unnecessary services.  The lawsuit stems from allegations that Techota made false claims for payments to Medicare for home health services that were not medically reasonable or necessary, or were not provided under […]