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OIG List 6 Home Health Questionable Billing Practices

Number 1 - HHAs that have a high average of outlier payment amounts per beneficiary. They stated their threshold was above $403 per beneficiary.

Number 2 - HHAs that billed unusually high number of visits per beneficiary. They stated their threshold was above 90 visits per beneficiary.

Number 3 - HHAs that had an unusually high percentage of beneficiaries for who other HHAs billed Medicare. The stated their threshold was 61 percent.

Number 4 - HHAs that had an unusually high numbers of late episodes per beneficiary. They stated the threshold was more than 2 late episodes per beneficiary.

Number 5 - HHAs that billed for unusually high numbers of therapy visits per beneficiary. They stated the threshold was above 23 therapy visits per beneficiary.

Number 6 - HHAs how had unusually high payments per beneficiary. They stated the threshold was $11,652 in payments per beneficiary.

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Learn about the New Proposed HH PPS Rules for 2013

Finally an On-Demand Seminar that Reviews the Proposed Home Health Rules and Rates for 2013

Where is your favorite place to be when you go on line? Now you can attend our On Demand seminar from that place or you can view it from your conference room with your staff. This seminar has two nursing and home health administrator CEU's. We know that it can be hard to get away to attend a one day seminar, now you can attend from your office or the comfort of your favorite spot. Presentation Includes: This presentation consists of two one-hour On-Demand Webinars on the Proposed Home Health PPS Rules and Rates for 2013. It covers the new proposed Medicare payment rates for 2013.  It explains the extensive changes in CMS new home health survey rules.  The presentation provides details on the proposed new alternate sanctions which include civil money penalties for home health agencies that are not in compliance with the Medicare COP's.  It reviews the proposed changes in the home health Face-to-Face encounter rules.  The seminar explains changes in the therapy supervision rules.  It will cover the proposed new case mix adjustment changes.  It explains the proposed revision and rebasing of home health market basket data from 2003 to 2010.  The seminar includes new information on OASIS data submission.  It covers updates on the home health CHAPS reporting.  The seminar also covers the changes in the hospice quality reporting rules.   LINK to On Demand Seminar PRICE:   $199  for each Agency with CEUs for one person CEUs for additional people from the same agency can be obtained for $79 each. If you have questions or need additional information please call Richard Dixon at  (321) 473-8561.