CMS Gets Aggressive on Medicare Claims, Denials Rise 24% in Q2

More healthcare providers are seeing their Medicare reimbursement claims denied and are needing to provide more information to the Center for Medicare & Medicaid Services (CMS) Recovery Audit Contractors (RACs), according to results of the American Hospital Association’s RACTrac Survey for the second quarter of 2012, as the agency continues its attempts to limit inaccurate […]

Detroit Home Health Manager Pleads Guilty in $13.8 Million Fraud Scheme

A Detroit man pleaded guilty yesterday in federal court to one count of conspiracy to commit health care fraud after managing a $13.8 million Medicare fraud scheme, according to the Federal Bureau of Investigation.  Jawad Ahmed managed home health agency Physicians Choice Home Health Care LLC (Physicians Choice), and used the company to deliver kickbacks to […]

Felons Turned Home Health Workers Caring for Elderly in California

Some of California’s elderly in need of home health services are being cared for by convicted felons, made possible in part by a flawed system that is “rife with loopholes,” reports the local NBC affiliate, allowing people to sign waivers allowing felon caretakers to care for them despite their backgrounds—and despite the criminal activity they […]

Hospitals Look to Home Care In Cutting Patient Readmissions

Medicare will begin penalizing 2,211 hospitals in October for having too many counts of patient readmissions, and some hospitals are looking to home health care as a solution to the readmission problem.  Severity of the Medicare penalties is based on the number of the readmissions for Medicare heart failure, heart attack and pneumonia patients between […]

Kindred Acquires Home Health Care Provider IntegraCare for $75 Millon

Home health care and hospice provider IntegraCare has been acquired by Kindred Healthcare, Inc. (NYSE:KND), a Louisville, Ky.-based long-term care and rehabilitation services provider, for up to $75 millon.  IntegraCare Holdings, Inc., is a Texas-based portfolio company of private equity firm Flexpoint Ford LLC, and was purchased for $71 million in cash plus up to […]

U.S. News: Health Reform Testing New Medicare Programs for Home-Based Care

While more attention has been paid to certain provisions of the Affordable Care Act regarding health insurance or the creation of new state health insurance exchanges, the comprehensive health reform law has also spurred the development of new programs looking for ways to provide cost-efficient, quality care in a variety of settings—including those that are […]

AARP: Seniors Fear Presidential Candidates Neglecting Medicare Issues

With the 2012 presidential campaign looming overhead, a July 2012 AARP survey finds aging Americans believe candidates are neglecting key issues, causing seniors to experience increased anxiety about retirement and their ability to afford healthcare as they age. Contributing to seniors’ uneasy feelings about retirement and healthcare are weaknesses in the Medicare and Social Security […]

Five Illinois Home Health Employees Indicted in $400,000 Kickback Scheme

Five Lincolnwood, Ill. home health agency employees were indicted Monday on charges for allegedly participating in a Medicare fraud scheme involving $400,000 in kickbacks for the referral and retention of Medicare beneficiaries, according to the U.S. Department of Justice.  In their kickback scheme, Goodwill Home Healthcare, Inc. billed Medicare for $5 million to cover their […]

Medicare Cuts Drive Amedisys Q2 Profits Down

Amedisys, Inc. (NASDAQ: AMED), provider of home health and hospice care, suffered a 65.8% decline in earnings per share (EPS), during the second quarter of 2012 due to large cuts in Medicare reimbursements and the implementation of Medicare’s face-to-face law, according the company’s second quarter financial report. Despite decline to an EPS of 27 cents, the company […]