LHC Group set­tles dis­pute with govern­ment for $65 mil.

Modern Healthcare - - LATE NEWS -

Home health provider LHC Group said it will pay $65 mil­lion to set­tle a civil in­quiry with the fed­eral govern­ment over whether some Medi­care-re­im­bursed pa­tient care was med­i­cally nec­es­sary. In the agree­ment, LHC Group did not ad­mit wrong­do­ing and said it still dis­putes the claims. The com­pany said there were no find­ings that the com­pany billed or re­ceived pay­ments for ser­vices not ren­dered. The in­ves­ti­ga­tion was dis­closed in 2010 af­ter the Wall Street Jour­nal re­ported that Medi­care data sug­gested sev­eral providers ap­peared to boost the num­ber of vis­its they made to pa­tients to 10 or above—the thresh­old at which Medi­care re­im­burses providers an additional $2,200. LHC said it chose to set­tle to avoid the ex­pense of a drawnout dis­pute. The in­quiry cen­tered on whether med­i­cal records, in some cases, prop­erly doc­u­mented med­i­cal ne­ces­sity of some pa­tient vis­its. The com­pany also said it agreed to a com­pli­ance pro­gram in­clud­ing reg­u­lar au­dit­ing and mon­i­tor­ing, a train­ing pro­gram for its cler­i­cal staff on record-keep­ing re­quire­ments, an in­ter­nal com­pli­ance depart­ment that will be in­volved in all com­pany op­er­a­tions and an em­ployee eval­u­a­tion pro­gram link­ing per­for­mance re­views to com­pli­ance.

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