The Oklahoma City-based home health provider Carter Healthcare will pay $22.9 million in order to resolve allegations that it paid physicians to induce referrals of patients that led to false claims to the Medicare and TRICARE programs. “The taxpayer dollars that fund Medicare and Medicaid are meant to support the delivery of health care services […]
Office of the Inspector General
A number of health care providers that billed Medicare for telehealth services likely did so in a fraudulent or wasteful manner, according to federal watchdogs. That finding and others like it dampen the chances of home health providers being able to bill for virtual care moving forward. That’s one major takeaway from a recent report […]
The federal government saw a return of nearly $1.9 billion in health care fraud settlements and judgments in 2021. Of this $1.9 billion, the Medicare Trust Funds received $1.2 billion, and the U.S. Centers for Medicare & Medicaid Services (CMS) received roughly $98.7 million. The Health & Human Services Office of Inspector General’s (HHS-OIG) annual […]
House lawmakers are pushing for more oversight of Medicare Advantage (MA) plans in light of concerns over higher spending, improper claim denials and access to treatment. A number of lawmakers on the House Energy and Commerce Committee’s oversight subcommittee examined the issue during a hearing that centered around the MA program on Tuesday. “I am […]
Medicare Advantage (MA) organizations have limited beneficiaries’ access to necessary care. They have also denied payments to providers for services that are covered under Medicare rules, as well as MA billing rules. That’s according to a report released Thursday by the Office of Inspector General (OIG). The report examined data over the course of one […]
Compassionate Homecare Inc., has agreed to pay $6.53 million to MassHealth in order to resolve allegations of unauthorized billing for services. The settlement irons out a 2018 lawsuit filed by the Attorney General’s office against Compassionate. The state’s lawsuit alleges that the company stole millions of dollars from MassHealth. Aside from the $6.53 million settlement, […]
Federal regulators have thrown weight behind ensuring that patients have a more active role in their care transitions. The Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) recently drafted compliance guidance for hospitals on the topic. Under the guidance, OIG requires hospitals to share a list of […]
When a public health emergency was declared last March, the Centers for Medicare & Medicaid Services (CMS) issued a variety of waivers allowing home health providers to more easily provide telehealth services during the crisis. Now, the Office of Inspector General (OIG) has announced an audit, dubbed the “HHA Telehealth Project,” that will examine home […]
Hospitals improperly coding for post-discharge services contribute to hundreds of millions of dollars in Medicare overpayments. And the majority of incorrect payments are often related to home health services. That’s according to a new audit report from the Department of Health and Human Services (HHS) Office of Inspector General (OIG). The purpose of the OIG […]
The Office of the Inspector General (OIG) is making good on its long-held promise to ramp up oversight of home- and community-based services, requesting an extra $10 million in its fiscal year 2020 budget to tackle fraud, waste and abuse in those areas. The extra funding — which would increase this portion of OIG’s budget […]