The Pennsylvania Department of Health today announced 127 long-term care facilities in 43 counties will receive a portion of Pennsylvania’s $14.2 million in federal Centers for Disease Control and Prevention (CDC) funding to help sustain quality care as the Commonwealth’s population ages and residents’ needs change. Local program grant recipients in McKean County include: Chapel Ridge, $43,500; Lutheran Home at Kane, $179,760; Lutheran Home at Kane / Residential Care Center, $62,085; and Sena Kean Nursing and Rehabilitation Center, $300,000. The grants were awarded through the Long-Term Care Quality Investment Pilot program, which was open to skilled nursing facilities (SNFs), personal care homes (PCHs), assisted living facilities (ALFs), and intermediate care facilities (ICFs) enrolled in the state’s LTC RISE program’s quality improvement work initiative.
A 63-year-old Sugar Land resident has been ordered to prison for conspiracy to pay and receive kickbacks, announced U.S. Attorney Alamdar S. Hamdani. Joyce Agu pleaded guilty Oct. 17, 2022. Today, U.S. District Judge Randy Crane ordered her to prison for a total of 60 months to be immediately followed by three years of supervised release. At the hearing, the court heard additional regarding Agu’s family and her charitable contributions. However, Judge Crane considered how extensive the fraudulent scheme was and the millions that were siphoned from the Medicare program. In handing down the sentence, the court noted the amount of fraud. At the time of her plea, Agu admitted she paid others to certify her clients for home health services in order to bill Medicare. These beneficiaries did not qualify for the services and, in some cases, did not receive them. Medicare paid Agu’s companies over $3 million based on the fraudulent claims. Agu was permitted to remain on bond and voluntarily surrender to a U.S. Bureau of Prisons facility to be determined in the near future.
Neither the Medicaid Act nor the 14th Amendment’s due process clause gives home-care eligible Medicaid beneficiaries a right to a notice and automatic hearing when they experience service gaps, a federal court said. The New Hampshire Department of Health and Human Services, therefore, didn’t have to give beneficiaries these procedural protections when their home-care was interrupted or delayed, the US District Court for the District of New Hampshire said.
A home healthcare company providing services in several states, including Ohio, to U.S. Department of Energy employees and contractors, among others, who were injured or became ill on the job has paid $9 million to resolve alleged violations of the False Claims Act. United Energy Workers Healthcare, Corp. and related entities paid $9 million to resolve allegations that they submitted false claims for payment to the U.S. Department of Labor for healthcare services to beneficiaries of the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). This settlement resolves allegations that, between January 2013 and March 2021, defendants submitted claims for payment for in-home healthcare services that were never provided or were medically unnecessary, in violation of the False Claims Act. Such alleged violations included billing for case management services not actually provided, instructing caregivers to charge for more time than actually spent with patients, providing and billing for services to beneficiaries that were not covered by the EEOICPA program, and providing services without possessing required licensures.
The Administration on Aging projects the number of Americans aged 65 and older will rise to 80.8 million by 2040, creating significant demand for home health delivery models in the US. To meet this demand, strategics, payors, and private equity are relying on mergers and acquisitions to build economies of scale. These efficiencies can solve chronic problems like staffing shortages, meet Medicare and Medicaid value-based care reimbursement requirements, and satisfy patient appetite to receive care at home. The shift towards value-based care reimbursement models by the Centers for Medicare and Medicaid Services will continue to drive investment in the home health sector. To understand this trend, it is important to consider several investing themes strategics are deploying to expand their value-based care capabilities.
Illinois home care workers and seniors are calling on the General Assembly to pass legislation that would increase pay to $18 per hour and new paid training programs. It was just a few hours ago that home care workers from across the state were here in the Capitol rotunda. They’re calling on state lawmakers to pass legislation to increase their pay. Terrie Powell has been a home care worker in East St. Louis for the past ten years. Although she loves her job, there needs to be changes. “I love my clients, they’re amazing. However, we just do not get enough money for what we do," Powell said. There are two pieces of legislation that home care workers are looking for the general assembly to pass. The first one would raise the minimum wage to $18 per hour. The current rate is set at $15.45.