Editor’s Picks: Fraud, Fraud, Fraud

This week, Home Health Care News readers read up on three main topics: reimbursement, coding and fraud. The Medicare Fraud Strike Force charged about 300 people—including some in the home health industry—in a variety of schemes that involved more than $900 million in fraudulent health care billings, and the Office of the Inspector General identified […]

OIG Flags 500 Home Health Agencies as Fraud Battle Intensifies

Federal authorities are turning up the heat even more in their battle against Medicare home health fraud. The top targets: More than 500 home health agencies and 4,500 physicians identified as having suspicious practices as compared with most providers nationally. To identify these providers, the Office of Inspector General (OIG) for the Department of Health and […]

OIG: Home Health Improper Documenation ‘Prevalent’

Insufficient documentation in home health is a primary cause of Medicare fee-for-service improper payments, a new report by the Department of Health and Human Services Office of Inspector General (OIG) has found. The report comes just after a federal audit concluded hospices had improperly billed Medicare by $268 million in 2015. The report underscored how the U.S. […]

Hospices Overbilled Medicare by $268 Million, Compromising Home Care

Hospices inappropriately billed for general inpatient care (GIP), and most of those services could have been provided in the home care setting instead, according to a recent report from the Office of Inspector General (OIG). About one-third of all billing in 2012 was found to be inappropriate, costing Medicare $268 million for the year, according […]

OIG Pushes for More Staff Background Checks in Home Health

Despite the close relationship between home health aides and patients, there are no federal laws or regulations requiring that home health agencies (HHAs) conduct background checks on their employees — a liability for the agency and a risk to the client. In fact, a recent review by the Office of Inspector General (OIG) found that […]

Home Health Aides Are No. 1 Medicaid Fraud Offenders

Home health care aides accounted for more criminal convictions in fiscal year 2014 than any other provider type investigated and prosecuted by Medicaid Fraud Control Units (MFCUs) throughout the United States. Out of 1,318 criminal convictions in 2014, 30% involved home health care aides, according to the recently released annual report on MFCU activity from […]

OIG to Focus on Home Health Payments, Hospice in Senior Living in 2015

The Office of the Inspector General (OIG) has released its work plan for 2015, addressing various issues relating to home health care and hospice.  Among the topics addressed are the home health prospective payment system, fraud, health screening, hospice patients’ length of stay in assisted living facilities and the appropriateness of hospices’ general inpatient care […]

Miami Woman Gets 6 Years For $6.5 Million Home Health Fraud Scheme

The owner and operator of a Miami, Fla., home health care company was sentenced to more than six years in prison Monday for her alleged participation in a $6.5 million Medicare fraud scheme, the U.S. Department of Justice (DOJ) announced.  Cruz Sonia Collado, 64, was an owner and operator of the now-defunct home health care […]

Operation Home Alone Nets 14 More Arrests in Third Wave of Fraud Busts

The third wave of a home care-related Medicaid fraud scheme that originated in Illinois has resulted in 14 more indictments, bringing the total number of defendants involved to 43, according to the Federal Bureau of Investigation (FBI). Last week’s indictments constitute the third round of charges stemming from Operation Home Alone, an initiative led by […]

OIG: 10 States Don’t Require Background Checks for Home Health Workers

Vetting home health care workers—via background checks or fingerprinting—has been an area of consideration for federal regulators in recent months, but a new report reveals not all states have practices in place to screen these employees.  Of the 50 states and the District of Columbia, only 41 states require home health agencies to conduct background […]