Home Health Fraudster Pleads Guilty to $13 Million Scheme

An owner of a Miami home health care company has pleaded guilty in connection with a $13 million Medicare fraud scheme involving kickbacks and bribes, the Department of Justice (DoJ) announced Tuesday.  Alexander Lara, of Hollywood, Fla., pleaded guilty to one count of conspiracy to commit health care fraud after allegedly paying kickbacks and bribes […]

Home Care Company to Pay $5 Million Over Doc Assessments

To resolve allegations that it violated the False Claims Act by submitting false home health care billings to Medicare and Medicaid, ResCare Iowa Inc. has agreed to settle for $5.63 million, the Department of Justice (DOJ) announced this week. The disputed billings mainly related to the requirement that doctors conduct face-to-face assessments of potential home health patients, […]

Ohio Gov. Sets Plans to Crack Down on Home Care Fraud

Ohio Gov. John Kasich (R) is taking a bold new step in combating fraud in the home care industry: phasing out up to 13,000 independent providers who bill Medicaid for in-home care, The Columbus Dispatch reports. The proposal, part of Kasich’s budget plan, aims to phase out thousands of providers over a four-year period through […]

D.C. Home Care Case Could Swell to $150 Million Class Action Suit

A class-action lawsuit filed this week by several Washington, D.C. home care workers could ultimately balloon into a $150 million case with as many as 6,000 plaintiffs as they seek reparation for alleged backpay owed to them by their former employers.  The bid for class-action status, filed Tuesday in D.C. Superior Court, arrives one month […]

CMS Names First Audit Contractor for Home Health, DME in 2015

Just before the close of 2014, the Centers for Medicare & Medicaid Services (CMS) awarded its first national recovery audit contract for the new year to Connecticut-based firm Connolly, LLC—the first of five to be awarded. The Region 5 contract awarded to the Connolly is national in scope and includes Medicare claims for Durable Medical […]

Addus HomeCare Expands Ohio Presence Through Latest Acquisition

Addus HomeCare Corporation (NASDAQ: ADUS), a provider of home and community-based services, announced this week it has acquired Priority Home Health Care, Inc., effective Jan. 1.  Headquartered in Cleveland, Ohio, Priority Home Health Care operates six offices in the Cleveland, Akron and Columbus areas, which are expected to produce revenues of approximately $11 million for […]

HHS Awards States $665 Million to Design, Improve Health Care Delivery

Twenty-eight states, three territories and the District of Columbia will be the beneficiaries to over $665 million in Affordable Care Act funding to design and test health care payment and service delivery models that strive to both improve health care quality and lower costs, Health and Human Services (HHS) Secretary Sylvia M. Burwell announced Tuesday. […]

Medicare, Medicaid Net $2.3 Billion in Health Care Fraud Recoveries in 2014

The U.S. Department of Justice (DOJ) obtained a record $5.69 billion in settlements and judgments from cases involving fraud and false claims against the government in the fiscal year ending September 30, the federal agency announced in a report Thursday. Of that total, $2.3 billion was recovered from health care-related frauds.  FY 2014 marked the fifth […]

Senate Proposes Bipartisan Competitive Bidding Bill

Following proposed legislation by the U.S. House of Representatives, the Senate has introduced a similar bill that would correct what some believe to be flaws in the Centers for Medicare & Medicaid Services’ (CMS) competitive bidding program for durable medical equipment (DME).  Late last week, Sens. Rob Portman (R-Ohio) and Ben Cardin (D-Md.) introduced the […]