When a public health emergency was declared last March, the Centers for Medicare & Medicaid Services (CMS) issued a variety of waivers allowing home health providers to more easily provide telehealth services during the crisis. Now, the Office of Inspector General (OIG) has announced an audit, dubbed the “HHA Telehealth Project,” that will examine home […]
The federal government saw $2.2 billion in civil fraud recoveries in 2020. Roughly 82% of those settlements and judgments — about $1.8 billion — were from matters related to the health care sector. That’s according to a recent report from Nashville, Tennessee-based law firm Bass, Berry & Sims. The report examined significant health care fraud […]
Over the past few weeks, government officials have seemingly restarted their aggressive oversight of Medicare-certified home health agencies. For much of 2020, government watchdogs took a measured approach to health care oversight and enforcement, allowing operators to focus their efforts on COVID-19 mitigation instead of paperwork and compliance. But multiple settlements and charges have been […]
Doctor’s Choice Home Care Inc. and two former executives have agreed to pay $5.15 million to resolve allegations that the home health agency provided “improper financial inducements” to referring physicians through “sham medical director agreements,” the U.S. Department of Justice (DOJ) announced earlier this month. DOJ had also alleged that the agency offered bonuses to […]
A Massachusetts-based home health company and its owners will pay millions of dollars to resolve allegations that they falsely billed the state’s Medicaid program, MassHealth. The home health company is Altranais Home Care LLC, located in Lowell. Massachusetts Attorney General Maura Healey announced Friday that the company and owners Constant Ogutt and Shakira Lubega will […]
Two Pittsburgh residents — and home health employees — have pleaded guilty in federal court to one count each of conspiracy to defraud the Pennsylvania Medicaid program and health care fraud. United States Attorney Scott Brady announced the guilty pleas last week. Between 2011 and 2017, both Terra Dean and Larita Walls admitted they played […]
The 2019 fiscal year concluded with the Department of Justice (DOJ) bringing in $2.6 billion in recoveries involving health care fraud and false claims. Home health-related fraud was a large part of these efforts. This marks the 10th consecutive year that the department’s civil health care fraud settlements and judgments have exceeded $2 billion. The […]
Federal watchdogs have tied a bow on a key part of one of the largest Medicare fraud schemes in history. The U.S. Attorney’s Office for the Southern District of Florida announced Friday that Rodolfo Pichardo and Marta Pichardo — husband and wife — were each sentenced to several years in prison for their roles building […]
In September, the owner and operator of an Atlanta-based in-home care provider pleaded guilty to defrauding Medicaid in a $1.2 million scheme. Shortly before that, a Boston-based in-home provider agreed to pay $1.95 million in a settlement to resolve allegations that it submitted Medicaid claims without physician authorization in August. These cases are both part […]
Federal watchdogs and health care policymakers are signaling plans to ramp up oversight of fraud, waste and abuse in 2020, especially when it comes to home health and hospice agencies. While the efforts are, in part, linked to the misuse of Medicare dollars by bad actors, they’re also simply a result of the U.S. health […]
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