OIG: Massachusetts home healthcare provider received $15.5M in Medicare overpayments

Ayla Ellison (Twitter) - Print  | 

Home Health VNA in Lawrence, Mass., failed to comply with Medicare billing requirements for 105 of 497 home health claims reviewed by HHS' Office of Inspector General during the audit period of Jan. 1, 2011, through Dec. 31, 2012, according to an OIG report.

The 105 claims that did not comply with Medicare billing requirements resulted in  Home Health receiving $314,406 in overpayments.

Extrapolating from the sample results, the OIG estimated Home Health received at least $15.5 million in overpayments from Medicare during the audit period.

In written comments to the OIG's draft report, Home Health disagreed with the OIG's findings. After reviewing the company's comments, the OIG maintained its findings.

Based on its findings, the OIG recommended Home Health refund the Medicare contractor $6.35 million in estimated overpayments for claims incorrectly billed that are within the three-year recovery period and work with the contractor to refund estimated net overpayments of $9.13 million that are outside the three-year recovery period. The OIG also recommended Home Health strengthen its procedures and identify claims in years after 2012 that did not meet Medicare payment requirements and refund any associated overpayments.

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