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NAHC Report: Issue# 2187, 5/2/2013
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OIG Provider Self-Disclosure Protocol Updated
Alleged Personal Care Medicaid Fraud Found in Missouri and Rhode Island
For Your Information: Weill Cornell Makes their Depression CAREPATH Available for Free
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OIG Provider Self-Disclosure Protocol Updated

The U.S. Department of Health and Human Services Office of Inspector General ("OIG") issued a Provider Self-Disclosure Protocol ("SDP") update on April 17, 2013. This revised SDP supersedes and replaces the 1998 notice. According to OIG, the health care industry has an obligation to take measures to detect and prevent fraud and abuse. This obligation includes implementation of procedures and mechanisms to investigate and resolve instances of potential fraud.

The SDP protocol announcement opens with a discussion of the benefits of disclosures, including the fact that OIG believes self-disclosures are indicators of an effective compliance program. As a result, persons engaging in self-disclosure deserve to pay lower damages. OIG expressed its commitment to work with members of the health care industry that use SDP to resolve improper payments. They’ve reduced the timeframe for completion of its investigation to damage calculation to 90 days from the date of the initial submission and to reduce settlement multipliers, usually a minimum multiplier of 1.5 times single damages.

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Weill Cornell Makes their Depression CAREPATH Available for Free

Along with the free PHQ-9 Training, Weill Cornell has made their Depression CAREPATH site available, including their Depression Care Management training, for free. A minimum fee to handle processing is charged for those desiring CE credits.

Below is the link to the website followed by a brief description of the training:

Depression Care Management
Continuing Nursing Education: 2 contact hours
Course Duration: Approx. 1.5 hours

The Depression CAREPATH online training targets home health clinicians and provides instruction on an evidence-based protocol for depression care management for older adults. The module explains the five main areas of depression care management: assessment, coordination of care, antidepressant medication management, patient and family instruction, and assisting patients in becoming active members of their own treatment.

Just click on the “Depression CAREPATH” logo to create an account or log in.

Visit the CARING Store online for the latest Resources

Alleged Personal Care Medicaid Fraud Found in Missouri and Rhode Island

On April 25, Angel’s Care Inc. (ACI), doing business as Angel’s Care Home Health Services, agreed to pay the state of Missouri $149,414 for billing Medicaid for services not rendered. ACI is a Medicaid provider of in-home personal care services. ACI claimed to have provided in-home personal care services after two clients were deceased, and after others were hospitalized, from September 2009 through November 2012.

Of the total $149,414 owed, ACI will pay $38,971.59 to the state for its fraudulent billings, $77.743.18 in damages, $25,000 in penalties, and over $7,000 to cover the costs of the state’s investigation.

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