Federal watchdogs and health care policymakers are signaling plans to ramp up oversight of fraud, waste and abuse in 2020, especially when it comes to home health and hospice agencies. While the efforts are, in part, linked to the misuse of Medicare dollars by bad actors, they’re also simply a result of the U.S. health […]
Category: Fraud
A Texas-based physician has been found guilty for taking part in a $16 million Medicare scheme. On Oct. 7, the U.S. Department of Justice (DOJ) announced that, after a six-day trial, Dr. Yolanda Hamilton was convicted of a single count of conspiracy to commit health care fraud and conspiracy to solicit and receive health care […]
A recent hospice-related court ruling may impact how federal watchdogs and whistleblowers go after home health agencies moving forward. Last month, the U.S. Court of Appeals for the Eleventh Circuit issued its long-anticipated decision in United States vs. AseraCare, a winding legal battle involving false claims allegations dating back to 2008. Hospice companies, other Medicare-reimbursed […]
A New York-based home care agency is being placed under the microscope for its treatment of immigrant workers. Allcare Homecare Agency Inc. allegedly threatened to report immigrant workers to Immigration and Customs Enforcement (ICE) agents when they complained about unpaid wages, according to a Friday statement from the New York State Attorney General’s Office. As […]
Home Health Provider Charged in Largest Ever Cash-for-Patient Scheme in NorCal The Bay Area’s largest home health care provider has been charged by federal prosecutors with paying doctors in a Medicare kickback scheme involving millions of dollars of payments in cash, Warriors tickets, designer handbags and more. Amity Home Health Care paid kickbacks to doctors, […]
Guardian Healthcare resolves allegations Boston-based Guardian Healthcare has entered into a financial settlement with MassHealth, the Massachusetts Medicaid program, according to Law360. The home-based care provider — which offers home health and home care services — agreed to pay $1.95 million to resolve allegations that it submitted Medicaid claims without physician authorization that the services were […]
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 […]
As restitution for violating state wage laws, a Massachusetts home health care company and its owner have been ordered to pay $162,000 in penalties and back wages to more than 230 employees. Massachusetts Attorney General Maura Healey announced Monday that Worcester-based Pinnacle Home Healthcare Services Inc. and owner Pauline Mwangi failed to pay caregivers their […]
A bipartisan group of U.S. lawmakers is looking to relax federal anti-kickback rules related to how, when and where physicians refer their patients. Doing so could mean smoother referral relationships for home health providers, especially the biggest ones and those operating within an accountable care organization (ACO). Efforts to loosen anti-kickback regulations come from the […]
Encompass Health Corporation (NYSE: EHC) — the largest operator of in-patient rehabilitation facilities (IRFs) in the country, with a network of hundreds of home health and hospice locations to boot — has agreed to pay $48 million to resolve false claims allegations. The Birmingham, Alabama-based company had previously disclosed the matter in its public filings […]
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