Fraud Watch: Miami Home Health Owners Indicted in Scheme

Three Miami Home Health Agency Owners Charged in Fraud Scheme Three Miami-area home health care agency owners were charged in an indictment for their alleged participation in a health care fraud scheme involving a now-defunct business, the Department of Justice (DOJ) announced in March. Ailin Consuelo Rodriguez Sigler, 39; Ziola C. Rios, 57; and Thomas […]

Texas Home Health Care Owners Make OIG’s Most Wanted List

The Office of Inspector General (OIG) has named a former owner of a Texas-based home health care company, Ebong Aloysius Tilong, among its “most wanted fugitives.” Tilong was indicted on charges of conspiracy to commit health care fraud, health care fraud, conspiracy to pay kickbacks, payment of kickbacks and conspiracy to commit money laundering in […]

Fraud Watch: Doctor’s Conviction Overturned

New Orleans Doctor’s Fraud Conviction Overturned A New Orleans-based doctor and owner of a home health care company will likely be released from federal prison after an appeals court overturned the original conviction. Dr. Pamela Ganji and Elaine Davis were convicted of health care fraud and conspiracy to commit health care fraud in 2017. Ganji […]

OIG Notes Uptick in Home Care Medicaid Fraud Enforcement

The federal government is ramping up its efforts to nab perpetrators of Medicaid personal care services (PCS) fraud. A similar trend has been noted in Medicare home health care. Fraud indictments of PCS providers or attendants rose 56% between 2012 and 2015, while convictions increased 33% during that time, according to a new Office of Inspector General (OIG) report. […]

Hospice Honeymoon with Regulations is Over

While the home health care industry has seen more and more regulations come through that pike, hospice may appear to be a bit more of a safe haven in post-acute care. However, increasing regulation pressures are likely to advance, according to Bill Dombi, president of the National Association for Home Care & Hospice (NAHC), and […]

Must-Read News: Fraud Prevention

Happy Monday, Home Health Care News readers, and welcome to October. Catch up on all things home health and home care with our weekly roundup of must-read news. Keep reading to see our most-read posts from last week—and why home health fraud is once again coming into the spotlight. Around the Web Atop the list is a […]

Why OIG is Cracking Down on Home Health Fraud

This summer, the Justice Department announced the largest health care fraud takedown ever, involving schemes across several health care settings resulting in approximately $1.3 billion in false billings. Major home health schemes were uncovered as part of the takedown, and the announcement sent a message to fraudsters—federal agencies are cracking down. The Department of Health and […]

Must-Read News: Health Homes Services Review

Happy Monday, Home Health Care News readers. Take a moment to catch up from the weekend on all things home health and home care with our must-read news. Keep reading to see our top stories from last week. The Department of Health and Human Services (HHS) Office of Inspector General  announced it will review health […]

New York Improperly Paid $1.4 Billion for Long-Term Care Plans

The state of New York improperly claimed reimbursements for a significant amount of Medicaid Long-Term Care (MLTC) plans, resulting in $1.4 billion in overpayments in fiscal year 2014, according to a report from the Office of Inspector General (OIG). MLTC plans include fixed monthly capitation payments to provide long-term care services to beneficiaries who are chronically […]

ACOs Saved Medicare $1 Billion in First Three Years

With the goal of reducing overall care costs, home health agencies are increasingly playing a role in accountable care organizations (ACOs), according to a recent report from the Office of Inspector General (OIG)—and the groups are saving money. In the first three years of the Medicare shared savings program, 428 ACOs served 9.7 million beneficiaries, achieving a net […]