The Department of Health and Human Services Office of Inspector General (OIG) has released its latest audit of a home health agency. It returns to frequent compliance concerns about homebound determinations and the need for skilled nursing services. The findings also noted a handful of HIPPS code errors that impacted payment.
 
Caretenders of Jacksonville, Fla., agreed that one claim was paid in error among the 100 claims that OIG had reviewed, but disagreed with OIG’s statement that 38 other claims were improperly billed.
 
Among the OIG examples included in the report:
 
‘The physical therapy assessment documentation for one beneficiary showed that, from the start of the episode, the patient was able to ambulate without an assistive device. During the episode of care, it was documented the beneficiary had no shortness of breath, was not at risk of falling, and had been cleaning over several days which is consistent with a level of mobility beyond that needed for basic activities of daily living. Therefore, leaving the home did not require a considerable or taxing effort.”