U.S. flag

An official website of the United States government

Dot gov

The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.


The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review of Selected Paid Claims with Therapy Services Submitted to Medicare by Total Patient Care Home Health, LLC for the Period October 1, 2002, through September 30, 2003," (A-04-05-02000)

September 20, 2005

Complete Text of Report is available in PDF format (506 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


Our objective was to determine whether selected home health claims that included therapy services provided by Total Patient Care Home Health, LLC (Total Patient Care) to Medicare beneficiaries met Federal requirements and were appropriately paid.  Home health episodes with 10 or more therapy services result in an increased payment to home health agencies.  A medical record review determined that 22 claims contained therapy services that were not reasonable.  Projecting the results of the overpayments in our random sample to the universe, the provider received an estimated $63,425 in overpayments for claims billed to Medicare.

We recommended that Total Patient Care work with the Regional Home Health Intermediary to reimburse the Medicare program $63,425 for unallowable therapy services, identify and submit adjusted claims for Medicare overpayments received subsequent to our audit period, and strengthen controls to ensure that the therapy services provided are reasonable and medically necessary.  In response to our draft report, Total Patient Care agreed with our findings.