Insurance giant Cigna (NYSE: CI) and home health coordination company CareCentrix have been accused of a fraudulent billing scheme, in which beneficiaries were allegedly overcharged for in-home medical equipment. Bloomfield, Connecticut-based Cigna is the fourth-largest U.S. health insurance company, according to Forbes. It contracts with other organizations that offer certain services and products to Cigna […]
In an action that’s been deemed the “largest criminal health care fraud takedown” in the Department of Justice’s history, 243 individuals — including home health care providers — have been charged for their participation in schemes involving approximately $712 million in false billings. The defendants are charged with various health care fraud-related crimes, including conspiracy […]
Suppliers of certain home health products soon will be able to bid for contracts to begin in 2017, the Centers for Medicare & Medicaid Services (CMS) has announced. There are nine product categories in this Round 1 2017 bidding, which is a recompete of the contracts awarded in the Round 1 Recompete of the Medicare […]
As one of the fastest-growing sectors in the United States, home health care is teeming with business activity. Here are some of the industry’s latest investments, acquisitions and partnerships: American Advisors Group Partners With Home Care Franchisor American Advisors Group (AAG), the nation’s leader in reverse mortgage lending, recently announced its partnership with Visiting Angels, […]
Just before the close of 2014, the Centers for Medicare & Medicaid Services (CMS) awarded its first national recovery audit contract for the new year to Connecticut-based firm Connolly, LLC—the first of five to be awarded. The Region 5 contract awarded to the Connolly is national in scope and includes Medicare claims for Durable Medical […]
The Centers for Medicare & Medicaid Services (CMS) has announced the next steps of its Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program, including the bidding timeline for the Round 2 re-compete and the national mail-order re-compete. As required by law, CMS made its announcements last Thursday, also launching a comprehensive […]
Following proposed legislation by the U.S. House of Representatives, the Senate has introduced a similar bill that would correct what some believe to be flaws in the Centers for Medicare & Medicaid Services’ (CMS) competitive bidding program for durable medical equipment (DME). Late last week, Sens. Rob Portman (R-Ohio) and Ben Cardin (D-Md.) introduced the […]
Following the Centers for Medicare and Medicaid Services (CMS) recent open door forum for home health, hospice and durable medical equipment providers, the National Association for Home Care and Hospice published a recap of important items and updates covered during the event. Among the issues currently at hand for CMS are home health conditions of […]
The Centers for Medicare & Medicaid Services (CMS) issued its final rule late October for durable medical equipment (DME) payment adjustments. The final rule for calendar year 2015, which is largely unchanged from the proposed rule in July, clarifies certain criteria related to DME, such as methodology for expanding the CMS’ competitive bidding program to […]
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 […]
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