As at-home care has increasingly become a more popular model for health care, a significant portion of fraud convictions over the last 10 years have involved personal care services attendants. Between 2014 and 2023, personal care services accounted for at least 34% of fraud convictions in some years and as much as 48% in other […]
OIG
Utilization of home health services fell in both urban and rural counties from January 2016 to March 2022 in the “high-utilization” categories, in part, due to the rural add-on payments. In 2018, the Centers for Medicare & Medicaid Services (CMS) implemented a rural add-on payment, or a percentage increase, at the request of Congress. That […]
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 […]
Audits from the U.S. Department of Health & Human Services’ Office of Inspector General (HHS-OIG) can often catch home health agencies by surprise. And after a slower audit period during the COVID-19 pandemic, experts told Home Health Care News that providers should expect a ramp-up in audits over the next year. Battling that element of […]
The home health industry should keep its collective eye on the U.S. Department of Health & Human Services Office of the Inspector General’s (HHS-OIG) recent audits on the hospice industry, because it soon could be next. As the home health space continues to grow, federal oversight and the scrutiny attached to the industry have grown […]
The traditional brick-and-mortar hospital system is broken, often leaving patients in a condition that’s worse than when they first arrived. That’s according to a May report from the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). The findings throw further support for facility-based care alternatives, including the types of hospital-at-home models […]
U.S. lawmakers have repeatedly highlighted a need to rethink the nation’s long-term care landscape in recent months, partly in response to the COVID-19 pandemic but also because of the country’s rapidly changing demographics. A recently published budget report from the House Appropriations Committee obtained by Home Health Care News offers further insight into that call […]
Federal watchdogs are once again setting their sights on perceived improper billing practices by home health agencies. In an audit report published last week, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) found that stronger oversight of Low Utilization Payment Adjustments (LUPAs) in home health care could have saved […]
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 […]
In a new report released Monday, the U.S. Department of Health and Human Services Office of Inspector General (OIG) highlighted dozens of its unimplemented recommendations for reducing fraud, waste and abuse throughout the Medicare and Medicaid systems. Many of the recommendations were tied to home health, hospice and personal care services, in addition to how […]
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