Category: Audits

OIG Report Identifies Common Characteristics in OIG Home Health Fraud Cases

Home health has long been recognized as a program area vulnerable to fraud, waste, and abuse. In 2015, Medicare reimbursed more than 11,000 home health agencies (HHAs) for almost 7 million episodes of home health care, totaling approximately $18.4 billion. From 2011–2015, OIG home health investigations resulted in more than 350 criminal and civil actions

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2017 OIG Work Plan for Home Health Agencies

The OIG has published their Work Plan for 2017, which summarizes new and ongoing projects the OIG plans to pursue with respect to HHS programs and operations. Why is that important to you? Because once the OIG identifies their areas of focus, audit contractors such as the Home Health and Hospice Medicare Administrative Contractors (HHH

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Audit Alerts – Jurisdiction D (Noridian)

Noridian Jurisdiction D recently announced the results of service specific prepayment reviews. Please see the list below to determine if the services you provide to beneficiaries’ in Jurisdiction D could be at risk for an audit. Codes that will remain on prepayment review due to recently published improper payment rates: • Therapeutic Shoes (A5500) •

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