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OIG Increases Its Focus on Physicians for Home Health Fraud

Posted in Fraud and Abuse, Home Healthcare, Legislation and Public Policy, Medicare and Medicaid, White Collar

In an alert issued on June 22, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services clearly announced its increased enforcement focus on physicians who have improper arrangements with home health agencies.

The OIG’s alert warns home health agencies and physicians about potential kickback violations tied to physician compensation agreements, noting that compensation agreements could violate the federal anti-kickback statute if “even one purpose of the arrangement is to compensate a physician for his or her past or future referrals of Federal health care program business.” Federal programs include Medicare and Medicaid, among others.
Other problematic areas identified by the OIG in the alert include falsely certifying patients as homebound, and billing for medical unnecessary services or services that were not rendered (such as physician home visits). Any physician who has a compensation arrangement with a home health agency would be well advised to have the agreement reviewed for legal compliance.

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