Unclear filing guidelines for Centers for Medicare & Medicaid Services’ (CMS) documents are costing home health care providers billions of dollars a year, a recent report shows. Thirty-two percent of home health claims did not have the requisite or complete face-to-face encounter documentation, which resulted in $2 billion in payments that should not have been made […]
Category: Home Health Care
The owner and operator of a Miami, Fla., home health care company was sentenced to more than six years in prison Monday for her alleged participation in a $6.5 million Medicare fraud scheme, the U.S. Department of Justice (DOJ) announced. Cruz Sonia Collado, 64, was an owner and operator of the now-defunct home health care […]
In the health care industry’s quest to lower avoidable hospital readmission rates, recent findings by state Medicaid Medical Directors (MMD) now highlight the high costs — and prevalence — of Medicaid readmissions. The 30-day Medicaid readmissions rates for 19 participating states varied, but accounted for an average of 9.4% of all admissions, according to MMD […]
Several home care fraud developments in New York, Rhode Island and Louisiana have led the National Assoication for Home Care and Hospice to recommend that providers “re-double” their internal efforts against fraud. The association points to findings from the National Council on Medicare Home Care, a NAHC affiliate, that show Medicare fraud activity in areas […]
Since Ohio’s new managed care plan for dual eligibles rolled out locally in July, home health workers — and their agencies — have been struggling to adjust to payment processing changes, The Columbus Dispatch reports. Before the plan, called “MyCare Ohio,” the government would process claims submitted by independent workers and home health agencies in […]
The state of Kansas is prepared to fight against a planned federal labor rule that would affect cost of home health care services, media report. Gov. Sam Brownback’s administration says the new rule will hurt Kansans who receive home-based services that allow them to continue to live in their own homes as it would increase the […]
The owner of three Detroit-Area home health agencies pleaded guilty Wednesday for his role in a $22 million home health care fraud scheme. Muhammad Aamir, 43, of Bloomfield Hills, Mich., admitted that, beginning in 2008 and continuing through January 2013, he conspired with others to bill Medicare for home health care services that were not […]
Each day, thousands of home-based caregivers are put into life-and-death situations with little training and virtually no direct supervision, mainly because state payments are too low to cover additional training and oversight expenses, reports the Star Tribune. The Minneapolis-based newspaper interviewed more than two dozen personal care attendants and found that only one had received […]
The U.S. Government Accountability Office (GAO) has found that the Centers for Medicare & Medicaid Services (CMS) does not have reliable data or sufficient oversight to measure and prevent duplication of postpayment claims reviews. CMS should provide additional oversight and guidance regarding data, duplicative reviews and contractor correspondence to improve effectiveness and efficiency of postpayment […]
Average overall rating of hospice care is 93 out of 100, according to the latest results of a survey by the Centers for Medicare & Medicaid Services (CMS). In the Hospice Experience of Care Survey, more than 1,100 individuals reported experiences from decedents receiving hospice care from 29 different hospice organizations. The survey is meant to act […]
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