Submitting OIG:
Report Description:
Excellent Home Care Services, LLC (the Agency) (located in Brooklyn, New York), did not comply with Medicare billing requirements for 156 of the 555 home health claims we reviewed. As a result, the Agency received net overpayments of $498,000 for calendar years 2011 and 2012. Specifically, the Agency incorrectly billed Medicare for some beneficiaries who were not homebound, some beneficiaries who did not require skilled services, and some services for which the documentation from the certifying physician was missing or insufficient to support the services. These errors occurred primarily because the Agency did not have adequate controls to prevent the incorrect billing of Medicare claims within selected risk areas.
Date Issued:
Thursday, July 14, 2016
Agency Reviewed / Investigated:
Submitting OIG-Specific Report Number:
A-02-14-01005
Component, if applicable:
Centers for Medicare & Medicaid Services
External entity, if applicable:
Excellent Home Care Services, LLC
Location(s):
NY
United StatesType of Report:
Audit
Questioned Costs:
$1,531,015
Funds for Better Use:
$0
Number of Recommendations:
4
View Document:
Attachment | Size |
---|---|
21401005.pdf | 8.99 MB |
Additional Details Link: