Home Health & Hospice Week

Fraud & Abuse:

ZPICs Take Down Home Care Providers

You might be next on the fraud contractors' hit list, experts warn. You could be in for a payment ambush that would close your doors forever if your documentation isn't pristine. Zone Program Integrity Contractors, which are Medicare's new fraud contractors, appear to be ramping up audits on home care providers throughout the United States, experts say (see related story, p. 252, for one example). Hundreds of home care providers are coming under the ZPICs' microscope, warns Tim Johnson with Jackson Davis HealthCare in Denver, which does ZPIC audit consulting. Recovery Audit Contractors have mostly focused their reviews on hospitals, and ZPICs have swooped in to cover reviews of smaller providers like home health agencies, hospices, and durable medical equipment suppliers, Johnson notes. In reports and congressional testimony, the government is depicting the home care industry as riddled with fraud, notes attorney Edward Vishnevetsky with Thompson Coe Cousins & Irons in [...]
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