Home Health

Provider pays $18.5M to resolve face to face, other Medicare claim allegations

Pennsylvania home health and hospice provider Geisinger Community Health Services (GCHS) will pay $18.5 million to resolve allegations of civil liability for submitting claims to Medicare for services that violated Medicare rules and regulations, according to the U.S. Attorney’s Office for the Middle District of Pennsylvania. After it discovered the problems, GCHS took corrective action and disclosed the matter, the Justice Department noted in a release.

According to the voluntary disclosures, between January 2012 and December 2017, through several affiliated entities, GCHS submitted claims to Medicare for hospice and home health services that violated Medicare rules and regulations regarding physician certifications of terminal illness, patient elections of hospice care and physician face-to-face encounters with home health patients. 

“The $18 million payment in this matter reflects the priority healthcare providers should place on making sure they closely follow all Medicare rules and regulations,” said Acting U.S. Attorney Bruce Brandler.  “Healthcare fraud remains a focus of the Department of Justice and the Affirmative Civil Enforcement Unit of the United States Attorney’s Office. I commend GCHS for taking this seriously, voluntarily disclosing these issues to our office and working to address the problems that led to these violations.”

Read the full release.