Medicare Compliance & Reimbursement

Fraud & Abuse:

78 HHAs Put On Suspension At Once As Part Of Fraud Bust

Be careful about which docs certify your patients for home care. It's not just home care providers getting collared in massive home care fraud schemes. The feds have charged a physician and his office manager in a $375 million fraud ring in the Dallas area. The charges: Physician Jacques Roy owned and operated Medistat Group Associates. Medistat was an association of health care providers that primarily provided home health certifications and performed patient home visits, the Department of Justice says in a release. Dr. Roy allegedly certified or directed the certification of more than 11,000 individual patients from more than 500 HHAs for home health services during the past five years, the DOJ says. Many of those were for medically unnecessary services and services never provided. Medistat allegedly maintained a "485 Department," the DOJ says. Dr. Roy instructed Medistat employees to complete the 485s by either signing his name by [...]
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