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Print A new federal report concludes that despite regular indictments and convictions of owners of home health care agencies, Medicare fraud is still alive and well in metropolitan Detroit. While data on home health agency fraud was not broken out by region, the U.
Teams are in Detroit, Miami and several other cities with high numbers of fraudulent providers. Criminal charges were filed against 1, defendants for crimes related to health care fraud and defendants were convicted, according to HHS.
The Office of Inspector General report found that home health agency fraud is especially troublesome. The report found one in four home health agencies provided questionable billing. However, the Office of Inspector General found that 98 percent of medical records for home health claims documented that Medicare beneficiaries met coverage requirements for home health services.
But as many as 22 percent of claims were filed in error because services were unnecessary or claims were coded inaccurately.
OIG indicated it was unclear whether the payments were fraudulent because the medical records were not reviewed, making it impossible to determine whether the services were justified based on patient conditions.
Clearly, home health agencies need to do a better job at record-keeping. They are to increase Medicare contractor standards to identify high-risk providers, track license revocation recommendations and prevent inappropriate payments to agencies with suspended or revoked licenses.
Inthe U. Department of Justice announced seven instances of fraud in Michigan. To read about them, click here.12 female CEOs making their mark in healthcare. Written by Megan Wood Baton Rouge Business Report named her the "Businessperson of the Year." 90 healthcare leaders under 40;.
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