Report on Medicare Compliance 29, no. 43 (December 7, 2020)
◆ In a new provider compliance audit,[1] the HHS Office of Inspector General (OIG) said The Palace at Home, a for-profit home health care agency (HHA) in Miami, Florida, was overpaid $30,387 for services provided in 2015 and 2016. OIG audited a stratified random sample of 100 claims and found errors on 20. OIG contended the beneficiaries were not homebound or didn’t require skilled care. “On the basis of our sample results, we estimated that The Palace received overpayments of at least $731,304 for the audit period,” OIG said. In a written response, the HHA disputed OIG’s findings.
◆ CMS has posted guidance on compliance with Medicare billing and documentation requirements for major joint replacements.[2]
◆ The HHS OIG has released its Semiannual Report to Congress.[3] The report “highlights more than $4 billion in expected investigative and audit recoveries identified during fiscal year (FY) 2020,” OIG said in a press release.[4]
1 Amy J. Frontz, “Medicare Home Health Agency Provider Compliance Audit: The Palace at Home,” HHS OIG, November 2020, https://go.usa.gov/x7dMb.
2 CMS, “Major Joint Replacement (Hip or Knee),” Medicare Learning Network, accessed December 4, 2020, https://go.cms.gov/3qpfSh1.
3 HHS OIG, Semiannual Report to Congress: April 1, 2020–September 30, 2020, accessed December 4, 2020, https://bit.ly/2JO6qmA.
4 HHS OIG, “HHS-OIG’s Work Could Save Taxpayers Billions of Dollars, New Report Says,” news release, December 2, 2020, https://bit.ly/33Mmf46.
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