Complinace a Key Issue for Home Health Providers
Following a detailed report in the Chicago Tribune on rampant fraud in the home healthcare industry, a suburban law firm is reminding the legitimate service providers to be diligent in maintaining compliance.
Lavelle Law in Schaumburg has operated one of the Chicago area's few practice groups dedicated to health law for over 20 years. Ted McGinn, the Managing Partner of the firm and head of the industry-specific practice group is not surprised by the report.
"The home healthcare industry has long been unchecked in Illinois and because of the lack of oversight on Medicare programs, has been an easy target for fraud," said McGinn. "The ease of entry into the industry combined with prompt reimbursement by Medicare has attracted unscrupulous operators. That being said, there are many highly competent and dedicated healthcare providers who have operated outstanding businesses for many years."
McGinn said that those providers must be even more vigilant about maintaining detailed records and adhering to all compliance requirements. "We have worked with dozens of home healthcare businesses over the years and the mantra remains the same - keep meticulous records, verify homebound status and medical necessity, and take no short cuts regarding compliance, especially with regard to Medicare." McGinn notes that a successful provider in this growing industry will have both highly qualified nursing personnel and an administrator who emphasis Medicare compliance. In addition to criminal investigations many agencies have been subjected to audits of claims, leading to Medicare recoveries of millions. "It is not a matter of if the agency will be investigated, but when. There is too much at stake to be lax."
From his two decades of dealing with health law, McGinn notes that the businesses he advises must be aware of HIPAA, Stark Law and the Anti-Kickback Law, Medicare eligibility requirements, and be knowledgeable of the 36 month rule. As more and more agencies are shut down, those that survive well have a bright future, provided they stay compliant.
Lavelle Law recently moved its main office from Palatine to Schaumburg, and maintains an additional office in the Loop. The firm was founded in 1989 as a single attorney practice with an emphasis on tax law. The firm has added more than a dozen practice groups including Estate Planning, Business Law, Banking Law, Litigation, Criminal, Immigration, Divorce and Family Law, Commercial and Residential Real Estate and Law Practice Consulting. The firm has received numerous awards and commendations for their business success, their commitment to ethics, national recognition for their pro bono services, and multiple acknowledgements of the charitable work they do in the local communities. For more information, visit www.lavellelaw.com or follow Lavelle Law on Twitter, Facebook and LinkedIn.