Federal Report Presses Medicare for Stronger Anti-Fraud Reforms

While Medicare fraud isn’t specific to any one sector of healthcare, it can be a blemish on industries like home health, which ultimately suffer due to a few bad actors. However, implementing several key integrity reform measures can help strengthen federal payers like Medicare from further abusive practices, according to a recent report from the […]

CMS: ACOs Yield $372M Medicare Savings, Better Patient Care

As Accountable Care Organizations (ACOs) continue to emerge in the home health care sector, the The Centers for Medicare & Medicaid Services (CMS) released quality and financial performance results Tuesday that show Medicare ACOs are having a positive impact. ACOs in the Pioneer ACO Model and Medicare Shared Savings Program generated over $372 million in […]

CMS Final Rule Gives Healthcare Providers Flexibility in EHR Use

The Department of Health and Human Services (HHS) published a final rule Friday that allows health care providers more flexibility in how they meet meaningful-use guidelines for the EHR Incentive Program reporting period for 2014, the Centers for Medicare & Medicaid Services (CMS) announced. Under the final rule, which left a previous proposal in May […]

Investigators Dismantle $60 Million Home Health, Pharmacy Fraud Ring

Federal investigators announced Friday the take down of a massive health care fraud scheme that involved more than $60 million of improper billing to Medicare and Medicaid and the convictions of 39 defendants in Michigan. Propagated by ringleader Babubhai Patel, 51, of Canton, Mich., the scheme involved 26 pharmacies, nine doctors and several home health […]

HHS Grants $106 Million to Support Home Care Programming

The Department of Health and Human Services (HHS) will issue $106.7 million this year in grant awards to 46 states to expand home visiting services to women during pregnancy and to parents with young children up to age five. Grant awards also apply to the District of Columbia, and five jurisdictions as part of the Maternal, Infant, […]

Minnesota HHS Funds $3.5 Million for HCBS Innovation Programs

The Minnesota Department of Health and Human Services is offering $3.5 million in funding to providers who implement innovative projects designed to improve home and community-based services (HCBS). The performance-improvement funding will go toward 27 projects in 39 Minnesota counties, and will allow providers of services to aging Minnesotans, people with disabilities and the deaf to […]

Miami Home Care Worker Pleads Guilty in $7M Kickback Fraud

An office worker with a Miami home health care company pleaded guilty Wednesday to her involvement in a $7 million fraud scheme, according to the U.S. Department of Justice. Lizette Garcia, 37, of Miami, pleaded guilty before U.S. District Judge Joan A. Lenard in the Southern District of Florida to one count of payment of […]

Operation Home Alone Nets 14 More Arrests in Third Wave of Fraud Busts

The third wave of a home care-related Medicaid fraud scheme that originated in Illinois has resulted in 14 more indictments, bringing the total number of defendants involved to 43, according to the Federal Bureau of Investigation (FBI). Last week’s indictments constitute the third round of charges stemming from Operation Home Alone, an initiative led by […]

90% of IL Hospice Employees Fail to Meet State Standards

Recently published findings from an audit of Medicaid and Medicare hospice providers found that 90% of those randomly sampled did not meet state hospice licensure requirements related to hospice workers. The Department of Health and Human Services Office of Inspector General conducted an audit to determine whether the Centers for Medicare & Medicaid Services’ (CMS) reliance […]