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Home Health Agencies Archives

OIG most wanted list includes TX home health care company owner

The Office of Inspector General (OIG) has named a former Texas health care company owner as one of its “most wanted.” The agency indicted the business owner on various criminal charges related to health care fraud, including conspiracy to pay kickbacks and money laundering.

Important Notice for Medicare Providers: Medicare Beneficiaries Identifier is replacing Social Security number

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 mandates removal of Social Security Number (SSN)-based HIC numbers from Medicare cards to address current risk of beneficiary medical identity theft. CMS will use a new MBI generator to assign over 150 Million MBIs beginning April 1, 2018, and continuing through December 31, 2019, for full implementation January 1, 2020. While CMS will continue to process transactions utilizing a beneficiary's current HIC number during the transition period, Medicare fee for service entities must modify their current processes and systems to be ready to submit or exchange the MBI by April 1, 2018. The current system requires a 9-byte SSN plus 1 or 2-byte BIC. The MBI system will require an 11-byte alpha numeric numeration system. All Medicare fee for services entities are advised to check all of their internal billing systems to be certain the software they are currently using will accommodate the new MBIs. During the transition period, Medicare entities will be allowed to enter either the MBI or HIC number. If you use vendors to bill Medicare, ask them about their MBI practice management system changes and make sure they are ready for the change.

Is your home health care agency at risk for non-compliance?

A home health care agency that receives government reimbursement for services provided must have a compliance program in place, and the business owner or Compliance Officer should be responsible for implementing this program.

Last of Texas Medicare fraud sentences handed down

A 52-year-old Texas woman was recently sentenced to serve 10 years in a federal prison and ordered to pay more than $23 million in restitution to Medicaid and Medicare. The FBI said the sentence was the last to be handed down in "a massive health care fraud case" run by Dr. Jacques Roy.

Elements to consider in a disaster response plan

With hurricanes Harvey and Irma recently wreaking havoc in Texas and the southern United States, the necessity of a disaster response plan for any business has become clear. Pharmacies, home health agencies and other medically based businesses have a few additional elements to consider when it comes to disaster response.

Considerations in selling a health care business

If you own a home health care agency, hospice or other health care-related business, a time may come when you start to think about selling it. Maybe you have reached the stage of life where you are considering retirement, or maybe you have found that holding on to the practice has become more of a chore than a labor of love.

RN sentenced to four years in Texas health care fraud

It's a little more than a 3-hour drive north of Austin to get to Rowlett. The Dallas suburb is home to a registered nurse recently sentenced to spend 4 years in a federal prison for her participation in a health care fraud that prosecutors said included nearly $375 million in false claims.

Study: Home health care suffers when doctors fail to communicate

Home health care professionals know it. And with the recent publication of a study in the Journal of General Internal Medicine, physicians, patients, patients' families and others might understand it as well: miscommunication by doctors can lead to negative health outcomes for seniors that result in hospital readmissions.

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