Gem City Home Care incorrectly billed Medicare for services provided to beneficiaries who were not homebound or did not require skilled services.
These are the findings of a Medicare Home Health Agency Provider Compliance Audit conducted by the Department of Health and Human Services Office of Inspector General.
According to audit findings, the home health operator did not meet Medicare billing requirements for 25 of the 100 home health claims reviewed. On the basis of these sample results, which totaled $40,621 for fiscal years 2016 and 2017, the audit reported that Gem City received overpayments of at least $2.67 million.
OIG provided Gem City with recommendations for refunding overpayments to Medicare. Meanwhile, Gem City stated that it takes significant exception with the audit and will appeal the findings.
