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: False Claims Act - Qui Tam

Senate Finance Committee says home health agencies game system

By Phillips & Cohen LLP

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The Senate Finance Committee has issued a report that shows three home health companies are engaging in top-down strategies to game Medicare. Internal documents from Amedisys, LHC Group and Gentiva show that therapists were encouraged to target the most profitable number of therapy visits, even when patient need may not have required such visits. The visit records also showed concentrated numbers of therapy visits at or just above the point which triggered a Medicare bonus payment.

The Committee said that the alleged practices, at best, "represent abuses" of the Medicare program. "At worst," it said, "they may be examples of for-profit companies defrauding" the program at taxpayers' expense.

The three companies cited get most of their revenues from Medicare. Home-health care, intended to save money be keeping patients out of hospitals, is one of the fastest-growing areas of Medicare spending.

Full post as published by False Claims Act - Qui Tam on October 03, 2011 (boomark / email).

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