Submitting OIG:
Report Description:
Under the home health prospective payment system (PPS), the Centers for Medicare & Medicaid Services pays home health agencies (HHAs) a standardized payment for each 60-day episode of care that a beneficiary receives. The PPS payment covers intermittent skilled nursing and home health aide visits, therapy (physical, occupational, and speech-language pathology), medical social services, and medical supplies.Our prior audits of home health services identified significant overpayments to HHAs. These overpayments were largely the result of HHAs improperly billing for services to beneficiaries who either were not confined to home (homebound) or were not in need of skilled services.Our objective was to determine whether Caretenders of Jacksonville, LLC (Caretenders), complied with Medicare requirements for billing home health services on selected types of claims.
Date Issued:
Friday, May 28, 2021
Agency Reviewed / Investigated:
Submitting OIG-Specific Report Number:
A-04-16-06195
Component, if applicable:
Centers for Medicare & Medicaid Services
Type of Report:
Audit
Questioned Costs:
$0
Funds for Better Use:
$0
Number of Recommendations:
2