In the latest Medicare home health agency (HHA) provider compliance audit, the HHS Office of Inspector General (OIG) said Mission Home Health of San Diego Inc. was overpaid $61,718 in 2015 and 2016, which OIG extrapolated to $5.9 million.[1] Here are examples from the report.[2] Mission Home Health disputed almost all the findings.
Example 1: A Beneficiary Was Not Homebound—Entire Episode
For one beneficiary, the medical records showed that the beneficiary was independent in activities of daily living (e.g., grooming, dressing, bathing, toileting, meal preparation, and eating). The beneficiary was able to walk more than 1,000 feet without an assistive device. There was no history of recent or recurrent falls. Leaving the home would not have required a considerable and taxing effort for this patient at the start of care. The medical records did not support that the beneficiary was homebound for the entire episode.
