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Fraud, Abuse, Or Retaliation
Where To Report Waste Fraud, Abuse, Or Retaliation

Metropolitan Jewish Home Care, Inc., Billed for Home Health Services That Did Not Comply with Medicare Requirements

Submitting OIG: 
Department of Health & Human Services 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.
Date Issued: 
Monday, May 20, 2019
Agency Reviewed / Investigated: 
Department of Health & Human Services
Submitting OIG-Specific Report Number: 
A-02-16-01001
Component, if applicable: 
Centers for Medicare & Medicaid Services
External entity, if applicable: 
Metropolitan Jewish Home Care, Inc.
Location(s): 
Brooklyn, NY
United States
Agency-Wide
Type of Report: 
Audit
Number of Recommendations: 
3
View Document: 
AttachmentSize
PDF icon 21601001.pdf2.87 MB
Additional Details Link: 
https://oig.hhs.gov/oas/reports/region2/21601001.asp

Related Open Recommendations

Recommendation Number Recommendation Status Significant Recommendation Additional Details
266780 Open No
For the estimated $2,979,377 overpayment for all claims outside of the Medicare reopening period, exercise reasonable diligence to identify and return overpayments in accordance with the 60-day rule, and identify any returned overpayments as having been made in accordance with this recommendation
266781 Open No
Exercise reasonable diligence to identify and return any additional similar overpayments outside of our audit period, in accordance with the 60-day rule, and identify any returned overpayments as having been made in accordance with this recommendation
Displaying 2 of 2 Recommendations