WASHINGTON—A recent report shows Medicare has continued to improperly pay millions for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) provided to enrollees during inpatient stays despite a major audit in 2018 and subsequent fix in 2020.
BOSTON—The owner of a home health agency has been sentenced in federal court in Boston in connection with a home health care fraud scheme.
WASHINGTON—The Department of Health and Human Services (HHS) and the Office of Inspector General (OIG) released their fall 2024 semiannual report to congress (SAR), which found more than $7 billion in expected recoveries and receivables from misspent Medicare, Medicaid and other health and human services funds.
WASHINGTON—The Office of the Inspector General (OIG) conducted an audit of 25 selected home health agencies (HHA) to determine if they expended taxpayer funds in accordance with the terms, conditions and requirements for Provider Relief Fund (PRF) payments. As a result of the review, the selected HHAs were found compliant with PRF guidelines.
WASHINGTON—The Center for Medicare & Medicaid Services (CMS) recovered Medicare payments to providers under the COVID-19 Accelerated and Advance Payment (CAAP) programs in compliance with federal requirements, according to an audit conducted by the U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG).
WASHINGTON—Home health agencies didn’t report more than half of the falls that Medicare home health patients hospitalized for falls with major injury experienced, according to a new study by the Department of Health and Human Services Office of the Inspector General (OIG).
CAPE GIRARDEAU, Mo. (October 7, 2022)—A durable medical equipment business owner from Jackson, Missouri was sentenced to 30 months in prison for health care fraud and ordered to repay $7.5 million.
ST. LOUIS (September 30, 2022)—United States District Judge Stephen R. Clark sentenced a woman from St. Charles, Missouri to four years and nine months in prison for her role in a $2.5 million fraud involving Missouri’s Medicaid program and a nearly $60,000 fraudulent Paycheck Protection Program loan.
Judge Clark also ordered Barbara Martin, 63, to repay $2,566,989 to Missouri’s Medicaid program and $58,295 to the U.S. Small Business Administration.
WASHINTON, D.C. (September 9, 2022)—More than 1,700 Medicare providers have indications that they fraudulently billed Medicare for telehealth services, according to a new report from the Department of Health and Human Services (HHS) Office of Inspector General (OIG). These providers billed telehealth services for about half a million beneficiaries and received a total of $127.7 million in Medicare fee-for-service payments.
MIAMI, Fla. (May 20, 2022)—VirtuOx, Inc., based in Coral Springs, Florida and operating Medicare approved independent diagnostic testing facilities (IDTF), has agreed to pay $3.15 million to resolve allegations that it submitted or caused to be submitted false claims to Medicare for reimbursement.
WASHINGTON, D.C. (December 17, 2021)—On November 16, Department of Health and Human Services Office of Inspector General (OIG) published the report titled, “Medicare Improperly Paid Suppliers an Estimated $117 Million Over 4 Years for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Provided to Hospice Beneficiaries.”
WASHINGTON, D.C. (September 18, 2020)—The Office of Inspector General (OIG) of the Department of Health and Human Services conducted an audit to determine whether the Centers for Medicare & Medicaid Services (CMS) ensured that MACs and QICs reviewed appealed extrapolated overpayments consistently and in a manner that conforms with existing CMS requirements.
