Tag: improper payments

OIG: Medicare overpaid HHAs nationally $191.8 million in audit period

A recent OIG report suggests that the MACs could be recouping money they believe was incorrectly paid for home health episodes that ended with five to seven visits, slightly above the LUPA thresholds in PPS. And they could be enforcing stricter oversight of periods just above new LUPA thresholds in PDGM. Twenty out of 25 […]

OIG report suggests CERT data could identify ‘high-risk’ home health agencies

A report from the Department of Health & Human Services (HHS) Office of Inspector General (OIG) recommends using Comprehensive Error Rate Testing Data (CERT) to identify “high-risk” home health agencies to help reduce improper payments and agency error rates. CMS didn’t agree with the recommendation, however. Instead CMS points to CMS’ fraud prevention system, targeted […]