Epstein Becker Green (EBG) guided a home health agency through a Medicare claims audit conducted by the U.S. Department of Health and Human Services’ Office of Inspector General. The audit had originally indicated that 25 percent of our client’s claims did not meet the criteria for home health coverage due to beneficiaries allegedly not being homebound.

Following this audit, the Centers for Medicare & Medicaid Services sought to recover an extrapolated overpayment. Through a rebuttal process, the error rate was dropped to 4 percent, but the home health Medicare Administrative Contractor still calculated an extrapolated error rate. After a further rebuttal and appeal process guided by EBG, an Administrative Law Judge issued a decision fully favorable to our client, agreeing that the audit did not apply the homebound criteria correctly and eliminating the disputed overpayment.

Results may vary depending on your particular facts and legal circumstances.

Jump to Page

Privacy Preference Center

When you visit any website, it may store or retrieve information on your browser, mostly in the form of cookies. This information might be about you, your preferences or your device and is mostly used to make the site work as you expect it to. The information does not usually directly identify you, but it can give you a more personalized web experience. Because we respect your right to privacy, you can choose not to allow some types of cookies. Click on the different category headings to find out more and change our default settings. However, blocking some types of cookies may impact your experience of the site and the services we are able to offer.

Strictly Necessary Cookies

These cookies are necessary for the website to function and cannot be switched off in our systems. They are usually only set in response to actions made by you which amount to a request for services, such as setting your privacy preferences, logging in or filling in forms. You can set your browser to block or alert you about these cookies, but some parts of the site will not then work. These cookies do not store any personally identifiable information.

Performance Cookies

These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. They help us to know which pages are the most and least popular and see how visitors move around the site. All information these cookies collect is aggregated and therefore anonymous. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance.