Medicare:

Allegations Against ABC Home Health Care

OSI-95-17: Published: Jul 19, 1995. Publicly Released: Jul 19, 1995.

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Pursuant to a congressional request, GAO investigated specific allegations regarding a home health care firm's participation in the Medicare home health care program, focusing on whether its employees: (1) altered or forged medical records to ensure continued home visits; (2) made more visits to patients than necessary; and (3) charged Medicare for costs unrelated to patient care.

GAO found that: (1) some local office managers directed current and former employees to alter patient records so that it appeared that the patients continued to need home health visits, and to continue visiting patients that no longer qualified for Medicare home health care; (2) the firm charged Medicare for the cost of acquiring other home health agencies by paying home health owners a small sum up front, and paying the balance as a salary under employment agreements; and (3) some managers directed their employees to market the home health care firm and its services with the intent of charging Medicare for these unallowable costs.

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