Fraud rampant in Illinois home healthcare industry
A Chicago Tribune investigation found Illinois is a “hot spot for fraud” among home health care agencies (HHAs), estimating they’ve improperly collected at least $104 million from Medicare and Medicaid over the past five years.
In one example, a Schaumburg, Illinois-based physician staffing business, Doctor at Home, is alleged to have falsely certified that patients required skilled nursing care at their homes in order to keep Medicare payments flowing from its more than 300 HHA clients. Company owner Diana Jocelyn Gumila even told her staff of doctors and physician assistants to “please minimize the use of the following words in your documentation: very stable and stable.”
In at least one case, Gumila directly overruled a Ewa Novak, MD, when she reported one certified patient no longer needed their services, writing in her chart that the patient had walked several blocks from the train station and did her own grocery shopping without any problems.
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John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.