Obama Budget to Curb DME Medicaid Reimbursement

The Obama Administration’s all-ecompassing 2015 Budget includes provisions that aims to limit Medicaid reimbursement for durable medical equipment (DME) in efforts to reduce federal spending in the coming year and beyond.  One of the main provisions included in the 2015 Budget details using Medicare bid rates under the DME Competitive Bidding Program for Medicaid reimbursement, […]

CMS Moves Closer to Fingerprint Background Checks in Home Health

Three years following a final rule that will allow for fingerprinting of workers—a measure targeting Medicare fraud—the Centers for Medicare and Medicaid Services is finally making plans to contract with a company to conduct the background checks, according to a Modern Healthcare report. The fingerprint screening is one of several mechanisms now allowed by the […]

Home Health Company Employee Sentenced in $74 Million Fraud Scheme

The administrator and employee of two Miami home health care companies has been sentenced to 60 months in prison for her role in a kickback fraud scheme amounting to $74 million.  Former administrator of LTC Professional Consultants and employee of Professional Home Care Solutions Inc., Myriam Acevedo, 63, of Miami pleaded guilty in May for […]

Joint Commission Reapplies for Home Health Accreditation Recognition

The Joint Commission has applied to renew its home health agency accreditation program, with the Federal Register soliciting public comment on whether the organization’s requirements meet or exceed the Medicare conditions of participation.  In order to provide reimbursable services to Medicare beneficiaries, home health agencies must meet certain requirements under the Social Security Act, which […]

NAHC: What the Government Shutdown Means for Home Health

Following the inability of the House, Senate, and White House to reach an agreement or compromise on funding for the Federal Government, the new fiscal year beginning October 1, 2013 started off with a government shutdown that has closed many departments or depleted their workforces.  However, the government shutdown will have only a minimal impact […]

Texas Home Health Companies Sue Government Over Medicare Privileges

Claiming wrongful termination of their Medicare billing privileges, two Texas-based home health agencies filed a class action lawsuit against a Medicare contractor and the Department of Health and Human Services (HHS).  Houston home health agencies Oakwest Healthcare Services Inc. and CJN Home Health Services Inc. claim that Medicare administrative contractor Palmetta GBA LLC and HHS […]

Home Health Medicare Fraudster Ordered to Pay $15 Million Judgment

The former owner and operator of Los Angeles-based GreatCare Home Health Agency has been ordered to pay up to the tune of nearly $15 million—approximately three times the losses suffered by Medicare as a result of the agency’s illegal practices. Hee Jung Mun, the home health agency’s owner, was issued a $14.9 million default judgment […]

Miami Vice Fraudster Pleads Guilty to $20 Million Home Health Scheme

The owners and operators of several Miami home health care agencies—including a former Miami Vice actor—pleaded guilty on Sept. 5 in connection with a health care fraud scheme involving Trust Care Health Services Inc., a now-defunct home health care company. Roberto Marrero, Sandra Fernandez Viera, and Enrique Rodriguez all pleaded guilty before U.S. Magistrate Judge […]

HHS to Investigate DME Competitive Bidding Program

The U.S. Department of Health and Human Services Office of the Inspector General (OIG) announced it will investigate the Centers for Medicare & Medicaid Services’ (CMS) controversial Competitive Bidding program for durable medical equipment (DME). The OIG informed U.S. Representatives Glenn “GT” Thompson (R-PA) and Bruce Braley (D-IA) of its decision to initiate an investigation […]

Home Health Part of HHS Initiative to Drive Health Information Exchange

The Department of Health and Human Services (HHS) recently launched an initiative meant to accelerate health information exchange (HIE) across acute and post-acute care settings, including home health.  On August 7, the Office of the National Coordinator for Health Information Technology and the Centers for Medicare and Medicaid Services (CMS) held a webinar on the […]