The Senate Finance Committee claims three of the nation’s largest home-health operators tailored the care provided to Medicare patients to maximize reimbursements, according to a Wall Street Journal report.
The committee says Amedisys, LHC Group and Gentiva Health Services encouraged employees to make enough home-therapy visits to qualify for bonus payments even if visits were not medically necessary. The SFC has recommended CMS stop using the number of therapy visits as a payment measure and instead use measures of patient well-being and health.
The committee launched the investigation last year following a Wall Street Journal report that analyzed the three companies’ patterns of care and Medicare-claims data.
Last week, in a case unrelated to the SFC’s inquiry, LHC Group reached a $65 million settlement with the Department of Justice to settle allegations of improper billing to Medicare, TRICARE and Federal Employees Health Benefits programs from 2006-2008.
Related Articles on Home-Health Fraud:
Maxim Healthcare to Settle Federal Healthcare Fraud Charges With $150M
Miami Physician Pleads Guilty to Prescribing Unnecessary Care in $25M Medicare Fraud Scheme
Patient Recruiter from Miami Healthcare Agency Pleads Guilty to $25M Medicare Fraud Scheme
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
