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South Florida’s New Home Health Agency Ban Extended

Due in part to South Florida’s status and reputation as the number one place for organized fraud in the country, specifically health care fraud, a federal moratorium on new home health agencies has been extended.

Under current federal health care law, a temporary ban can be put in place to prevent the enrollment of new providers or suppliers for Medicare, Medicaid, or CHIP. The purpose of the ban is to prevent fraud, waste, and abuse. The idea is that while federal authorities make a concerted push to fight against healthcare fraud, suspect parties cannot enroll under new names for reimbursement under the various health care laws.

Because of the extremely high rates of organized fraud in South Florida, especially health care fraud, a moratorium was put in place on the licensing of new home health agencies in Miami-Dade, Monroe, and Broward Counties. The Miami-Dade and Monroe bans were initially put in place in July 2013 and Broward’s was in January 2014. The latest notice extends the ban through January 2016.

Considering recent data that marks South Florida as number one in the country for organized fraud, it is not a surprise the Feds decided to extend the ban. The latest Health Care Fraud and Abuse Control Program Report by the Department of Justice and the Department of Health & Human Services (published earlier this spring) illustrates how serious federal agencies are taking the fight against healthcare fraud. In Fiscal Year 2014, the Department of Justice opened 924 new criminal health care fraud investigations; 782 new civil health care fraud investigations; and had 957 civil health care fraud matters pending at the end of the fiscal year.

The report also focused on hot spot regions exhibiting signs of high levels of fraud. For example, the 2015 report found Medicare payments for home health care in the Miami area increased from about $90 million in 2006 to more than $250 million in 2010. HHS’s Office of Inspector General, in its 2012 report, found aberrant billing patterns in home health outlier payments in 24 counties across the country. Miami-Dade County accounted for more home health outlier payments in 2008 than the rest of the nation combined.

It is no surprise the authorities are maintaining a watchful eye on our region. It is important for health care professionals who are involved on the provider and supplier side to carefully monitor their billing, patient, and business practices in order to catch any fraud by employees and to be prepared in the event of a federal investigation.

If you think you need a lawyer, YOU DO. Call Now!

Are you looking for a skilled attorney who can help defend you against various types of fraud charges? Please contact Attorney Tony Moss at the Tony Moss Firm, L.L.C. to discuss these, or any other white-collar criminal defense matters. He has locations in Miami and Fort Lauderdale, and is prepared to put his 27 years of experience to work for you.

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