OIG Believes Unreported Falls Show ‘Poor Compliance,’ But Home Health Advocates Disagree

Home health agencies aren’t reporting more than half of falls involving major injury or hospitalization on patient assessments for Medicare beneficiaries, a recent report from the Office of Inspector General (OIG) found. In order to compile this report, OIG looked for falls with major injury in Medicare hospital claims for home health patients, and then […]

OIG: Iowa Overpaid Medicaid-Reimbursed Home Health Providers by $37.1M

The state of Iowa did not sufficiently monitor its health home care program providers for at least four years, resulting in tens of millions of dollars in improper reimbursement, the Office of Inspector General (OIG) found upon review.  The Medicaid health home care option allows states flexibility in creating programs that produce care coordination and […]

OIG: ACOs Need to Get Better at Health IT

Technology is key to helping accountable care organizations (ACOs) coordinate better patient care — yet ACOs still aren’t leveraging health IT to its full potential. That’s according to a report from the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG). OIG officials interviewed providers and staff from six different ACOs […]

Home Health Investigations Help OIG Recover $2.91 Billion in 2018

For years, the Department of Health and Human Services Office of Inspector General (OIG) has been ramping up efforts to battle Medicare fraud — including in home health and hospice. Now, a new OIG semiannual report is showing the agency’s progress, to the tune of $2.91 billion in expected investigative recoveries for fiscal year 2018. […]

OIG: Home Care Medicaid Fraud ‘Persistent,’ Harms Patients

Fraud and abuse in home health has led to an array of crackdowns from regulators and other authorities, but fraud issues are similarly rampant in Medicaid personal care services, according to a recent report from the Office of Inspector General (OIG). In many cases, patients have been harmed as a result. OIG has found “significant […]

Hospice to Shell Out $3 Million for Alleged Medicare Fraud

Guardian Hospice of Georgia LLC, Guardian Home Care Holdings Inc. and AccentCare Inc—collectively known as Guardian, a for-profit company that provides hospice services in Atlanta, Georgia—agreed to pay $3 million following allegations that it submitted false claims to Medicare for hospice patients who were not terminally ill. The Justice Department announced the settlement resolves allegations […]