Decatur County Memorial Hospital Agreed to Pay $3.7 Million for Allegedly Violating the Civil Monetary Penalties Law for Submitting Claims for Home Health Services Not Provided as Claimed

After it self-disclosed conduct to OIG, Decatur County Memorial Hospital (Decatur), Indiana, agreed to pay $3,757,615.50 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that Decatur improperly submitted claims for home health care where the underlying patient files contained the following deficiencies: (1) venipuncture identified as the only skilled service furnished for purposes of justifying Medicare home health eligibility; (2) missing or incomplete documentation; (3) certifications and orders unsigned or undated by physicians; (4) lack of documentation to support the patient’s skilled need or homebound status; and (5) documentation indicating that the requisite physician face-to-face encounter was not timely performed, or the absence of any face-to-face encounter documentation.

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