Hospice Insights Podcast: What’s the Latest on UPICs? Highlights from Recent Audit Activity, Part I
AGG Talks: Home Health & Hospice Podcast - Episode 5: Understanding Palliative Care: Strategies for Compliance and Reimbursement
Hospice and Home Health Survey Perspectives: A Conversation with Kim Skehan, VP of Accreditation at CHAP
Episode 172: Matthew Roberts and Lauren DeMoss, Maynard Nexsen Health Care Attorneys
A Very “Special” Episode: Amid Controversy, CMS Launches the Hospice Special Focus Program
Grace from CMS: Unexpected Good News on HIS and CAHPS Appeals
This Bandwagon Has a Broken Wheel: OIG Joins the Inconsistent Approach to Hospice GIP Claims
Beyond Hospice: Home Health Agencies Plagued by UPICs and SMRCs
Beyond Hospice: The OIG Renews Its Scrutiny of Home Health Agencies
DOJ and Treasury Announce Multilateral Russian Oligarch Task Force Called “REPO” - On March 16, 2022, Attorney General Merrick Garland and Secretary of the Treasury Janet Yellen met with representatives from Australia,...more
The Department of Justice recently announced that a home-health services company has agreed to pay over $45,000 to resolve alleged False Claims Act (“FCA”) violations. Professional Family Care Services, Inc. (“PFCS”), a North...more
Massachusetts AG Maura Healey sued home health agency Prestige Health Care Services, Inc. and related individuals (collectively “Prestige Health”) over allegations that Prestige Health falsely billed the state’s Medicaid...more
A group of New Jersey home health care companies (collectively, the BAYADA Companies), have agreed to pay $17 million to resolve claims that they violated the False Claims Act and Anti-Kickback Statute. Home Health Agency...more
The U.S. Department of Justice announced on November 20 that Doctor’s Choice Home Care, Inc. agreed to pay $3,856,000 to resolve allegations that the agency paid illegal kickbacks to physicians for referring patients. The...more
Report on Medicare Compliance 29, no. 39 (November 2, 2020) - Medtronic USA Inc., a medical device maker, has agreed to pay $8.1 million to settle allegations it violated the False Claims Act by paying kickbacks to induce...more
The Visiting Nurse Service of New York (VNSNY) has agreed to pay $57 million to settle a whistleblower lawsuit that alleged it billed the Medicare and Medicaid programs for hundreds of millions of dollars in home care visits...more
Home Health Care Employees Plead Guilty in Multi-Million Dollar Medicaid Fraud Scheme - Two individuals pled guilty in Pennsylvania federal court to conspiracy to defraud the Pennsylvania Medicaid program and commit...more
In this second installment of the Healthcare Enforcement Quarterly Roundup for 2019, we cover several topics that have persisted over the past few years and identify new issues that will shape the scope of enforcement efforts...more
Patient Recruiter Convicted in $1.3 Million Kickback Conspiracy Scheme - After a six-day trial, a federal jury in Detroit found a patient recruiter guilty of one count of conspiracy to pay and receive health care...more
Frequent regulatory and policy changes, increasing government scrutiny and private whistleblower activity pose greater risks to health care organizations more than ever before. McDermott’s Q2 Health Care Enforcement Roundup...more
On June 11, 2018, the United States Court of Appeals for the Sixth Circuit sustained a complaint against a home health care agency alleging that the agency had violated the False Claims Act (the “FCA”) by submitting numerous...more
A divided panel of the U.S. Court of Appeals for the Sixth Circuit again revived an FCA suit against home-health services providers premised on the providers’ alleged improper procurement of physician medical necessity...more
The District Court for the Middle District of Tennessee held on June 22, 2017, that the timing requirements related to a physician's certification of need for home health services were not "material" to the Centers for...more
The Medicare Fraud Strike Force initiated its largest ever healthcare enforcement action, charging 412 defendants in July 2017 with approximately $1.3 billion in fraudulent claims. The Strike Force consists of teams that...more
The US Department of Justice announced that Khaled Elbeblaswy, the former owner and manager three Miami-area home health agencies, was sentenced to 20 years in prison and ordered to pay $36.4 million in restitution for his...more
On June 22, 2016, the Office of Inspector General (“OIG”) issued two communications that underscore its continued focus on fraud in home health care, along with the role of physicians as “gate keepers” in authorizing...more