Medicare Administrative Contractor CGS recently released a new three-page document on fraud and abuse in home health and hospice. The document, published Aug. 16, looks to educate employees on recognizing fraud and abuse.
“If you work with patients receiving home health & hospice services it is vital to be informed about all aspects of fraud,” the document introduction states.
The guidance notes that home health fraud and abuse can include:
- Upcoding the types of services provided to receive higher payment
- Submitting bills for patients who are not homebound
- Visits by home health staff that are not medically necessary
- Home health visits that a doctor ordered, but the patient did not receive
- Bills for services and equipment a patient never received
- Fake signatures on medical forms or equipment orders
- Pressure to accept items and services that are not necessary or that Medicare does not cover
- Home health services provided that were not ordered by a physician
- A home health agency that offers free goods or services in exchange for Medicare numbers