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Fraud? Medicare and Home Health Physical Therapy

what you should expect. when you should question.


Fraud? Medicare? The terms are peas in a pod. They are also on the rise these days. Let's admit it, health care is no longer a profession but a business. And a business is run for profit.

When I started home care physical therapy 16 years ago, my patients were sick... bed bound... acute strokes, heart attacks, total joint replacements. They could barely walk, barely breath and some barely made it.

Today, many of them are barely home bound which is a requirement for medicare to pay the bill. There are exceptions but they are pretty well defined.

There are many factors that play into the home health care fraud of Medicare. These include:

  • Pt's are not home bound.

  • Agency's get more money for sicker people. If you can be made to look sicker than you are on paper - who's watching? No one... just you, (the patient) and the paid clinician.


  • Physical Therapy pay can be on a "you see a patient, we'll pay you" basis.

  • Multiple and sometimes unnecessary 60 day episodes for physical therapy only can generate high reimbursement from Medicare
  • There are many more and some of the areas of shady. Follow these next few pages to discover what you should be aware of, concerned about and when you should call your agency vs. calling your state hotline number.

    INDIANA STATE HOME HEALTH HOTLINE - 1.800.227.6334MEDICARE FRAUD HOTLINE - 1.800.447.8477

    Click here to report fraud to Medicare

    To report abuse, neglect or exploitation call toll free - 1.800.545.7763 x 20135

    With so many factors playing in to fraud and Medicare - it will serve us well to look in depth at several of them.


    How does a Home Care Agency Get Paid?

    How does a Physical Therapist get paid?

    Home Care Blog

    Back Home from Medicare Fraud


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