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OIG Online Portfolio: Home Health

Guidance

Home health providers seeking information about how to comply with the laws affecting their industry may find the below resources useful.

General Compliance Resources

  • Alert: Improper Arrangements and Conduct Involving Home Health Agencies and Physicians
  • Provider Compliance Training
    These videos and audio podcasts developed as part of the award-winning initiative provide free training for health care providers, compliance professionals and attorneys.
  • Compliance Program Guidance for Home Health Agencies
    Compliance program guidance is intended to assist home health agencies develop effective internal controls that promote adherence to applicable Federal and State laws. The adoption of voluntary compliance programs significantly advances the prevention of fraud, waste and abuse in these health care plans and furthers the fundamental mission of all home health agencies, which is to provide quality care to patients.
  • Home Health Agency Center
    This compilation of resources from the Centers for Medicare & Medicaid Services includes links to proposed and final rules, educational resources, initiatives and other materials of interest to the home health industry.

Corporate Integrity Agreements

OIG negotiates corporate integrity agreements (CIAs) with health care providers and other entities as part of the settlement of Federal health care program investigations arising under a variety of civil false claims statutes. CIAs have many common elements, but each one addresses the specific facts at issue. Examples of CIAs with home health agencies include:

  • Amdedisys, Inc. and Amedisys Holding, LLC
    "Amedisys Inc. and its affiliates (Amedisys) have agreed to pay $150 million to the federal government to resolve allegations that they violated the False Claims Act by submitting false home healthcare billings to the Medicare program, the Department of Justice announced today. Amedisys, a Louisiana-based for-profit company, is one of the nation's largest providers of home health services and operates in 37 states, the District of Columbia and Puerto Rico." Read the Entire Release from the U.S. Department of Justice
  • Atlas Healthcare Inc.
    "The Acting United States Attorney for the Eastern District of Wisconsin, Gregory Haanstad, announced today that the United States has reached a civil settlement agreement with Atlas Healthcare, Inc., and its owners, Deana Bajanen and Sheena Jones, for $435,000 pursuant to the federal False Claims Act. Atlas is alleged to have knowingly submitted false claims for personal care worker services to the Wisconsin Medicaid Program for patients that did not need the services or did not need the level of services for which Atlas billed the Medicaid program." Read the Entire Release from the U.S. Department of Justice

Advisory Opinions

OIG issues advisory opinions about the application of OIG's fraud and abuse authorities to the requesting party's existing or proposed business arrangement. One purpose of the advisory opinion process is to provide meaningful advice on the application of the anti-kickback statute and other OIG sanction statutes in specific factual situations.

Below are opinions that may be of particular interest to the home health industry:

  • Advisory Opinion 15-12: regarding a home health provider's policy to offer free introductory visits to patients who have chosen it as their home health provider
  • Advisory Opinion 12-17: regarding a proposal for a hospice to establish a volunteer program to provide non skilled services to terminally ill patients who do not qualify for hospice care
  • Advisory Opinion 07-16: regarding a home health agency's practice of providing prospective orthopedic patients with free educational videos containing instructions for postoperative home-based convalescence
  • Advisory Opinion 06-01: regarding a home health agency's practice of providing prospective customers with a free preoperative home safety assessment
  • Advisory Opinion 03-04: concerning a proposed program to provide free medical-alert pagers and pager monitoring service to homebound patients during the period that they are receiving your company's home health services

Page last updated: June 22, 2016

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Office of Inspector General, U.S. Department of Health and Human Services | 330 Independence Avenue, SW, Washington, DC 20201