KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Amedisys To Pay $150 Million To Settle Medicare Fraud Case

Amedisys Inc., one of the nation's largest home health providers, will pay $150 million to settle claims that it exaggerated Medicare billings and had improper financial relations with referring physicians, the Department of Justice revealed. Meanwhile McClatchy is reporting that, based on an analysis of Medicare's list of banned providers, Miami is at the top for Medicare fraud.

The Associated Press: Feds: Home Health Company Paying $150 M Settlement
Amedisys Inc., a Baton Rouge-based home health company, will pay $150 million to resolve allegations that it inflated Medicare billings and had improper financial relationships with referring physicians, the U.S. Department of Justice said Wednesday. Amedisys and its affiliates make up one of the nation’s largest home health providers, operating in 37 states, Washington, D.C., and Puerto Rico, according to a Justice Department news release (4/23).

The Wall Street Journal: Amedisys To Pay $150 Million to Resolve Medicare Fraud Allegations
The Department of Justice had been investigating allegations that between 2008 and 2010, Amedisys billed Medicare for services that were medically unnecessary, and misrepresented patients' conditions to increase its payments from Medicare, the U.S. Attorney in Philadelphia said in a statement Wednesday. Based in Baton Rouge, La., Amedisys provides at-home nursing care and physical therapy in 37 states (Whalen, 4/23).

McClatchy: In Miami, There’s No Shortage Of Medicare Fraud To Keep Prosecutors Busy
If there ever was any question that Miami is the champ when it comes to health care fraud, a peek inside Medicare’s list of banned providers should settle it. Of all the people and businesses in the federal government’s “exclusions database,” Miami tops the list – and does so by a long shot, according to a McClatchy analysis. Of the medical providers in the database, 1,491 list Miami addresses. Second place: Los Angeles, with a relatively meager 522 names. They’re followed by Phoenix; Brooklyn, N.Y.; and Houston in the top five (Adams, 4/23).

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