Home health care has long been recognized as vulnerable to fraud, waste, and abuse. Medicare reimburses more than 11,000 home health care agencies for their services. They estimated that $10 billion of those payments—more than half of the total reimbursement—were improper or fraudulent. The. Fraud Red Flags.. Unnecessary services. Performing an unnecessary medical service in order to receive Medicare compensation is a common form of Medicare fraud. False price reporting. This occurs when false price information is submitted to Medicare regarding the true cost of a product or service. Inadequate medical documentation.

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OIG Report Overview. The OIG report, released on September 2, was based on a comprehensive analysis of Medicare claims data from providers who billed for telehealth services in 2020. Using input from OIG investigators, the researchers identified seven measures to identify billing for telehealth services that may indicate fraud, waste, or abuse.. In conclusion, being aware of the red flags of Medicare fraud is the first line of defense in protecting yourself and the healthcare system. Remember, Medicare fraud not only impacts the financial stability of the program but also compromises the quality of care that individuals receive. By staying vigilant and reporting any potentially.