Compliance News Roundup: Home Care Compliance on the OIG’s Radar

1. Decatur Hospital Authority, d/b/a Wise Health System in Decatur, Texas Will Pay $431,182.96 to the United States for Services Rendered to Patients That Were in Violation of the Federal False Claims Act – “Memphis, TN – Decatur Hospital Authority, d/b/a Wise Health System in Decatur, Texas will pay $431,182.96 to the United States to resolve allegations of billing false claims to Medicare for genetic testing panels for surgical patients that were not medically reasonable or necessary.” Get the full scoop >>

2. Texarkana Physician Agrees to Pay $118,000 to Settle Medicare Billing Fraud Allegations - “Pursuing healthcare fraud is a top priority for my office,” said U.S. Attorney Joseph D. Brown. “When providers such as Dr. Douglas enrich themselves at the expense of Medicare, we will hold them to account.” Get the full scoop >>

3. Deeper Than the Headlines: Home Care Compliance on the OIG’s Radar - In May 2019, the OIG released audits they’d performed on Home Care agencies. In the end, they reached the conclusion that numerous services were out of compliance. Under the home health prospective payment system (PPS), the Centers for Medicare & Medicaid Services pays home health agencies (HHAs) a standardized payment for each 60-day episode of care that a beneficiary receives. The PPS payment covers intermittent skilled nursing and home health aide visits, therapy (physical, occupational and speech-language pathology), medical social services, and medical supplies. Get the full scoop >>