“Companies are doing everything they can to make as much money as possible, whether the patients need the care or not,” Grassley said in a written statement. “The federal government needs to fix the policy that lets Medicare money flow down the drain.”
The committee examined the billing practices of four public home-healthcare companies, and concluded from internal records that three of them—Amedisys, LHC Group, and Gentiva—maintained “top-down” policies to boost Medicare revenue by targeting the most profitable patients for extra care and using various internal incentives and policies to encourage employees to increase the number of profitable therapy visits.
The fourth company, Almost Home, maintained therapy-boosting policies, but its records did not show evidence of a “top-down” strategy, the report says.
Amedisys, Baton Rouge, La., said in a statement the company was pleased the investigation had ended, but was “disappointed” with the conclusions. “We stand by our company's integrity, ethics and patient-care practices,” the statement said.
A 21-page open letter to Amedisys shareholders in July 2010 stated the company's billings were consistent with standard industry utilization rates, including the trend that sicker patients had received more care than healthy ones. The company provided care prescribed by physicians, who are not compensated for referrals, the Amedisys letter said.
Officials with the three other companies did not respond to requests for comment Monday morning.
On Sept. 30, LHC Group, Lafayette, La., announced a $65 million settlement of a civil investigation into whether the company was providing medically necessary care. The company did not admit wrongdoing as part of the settlement, which included a release of liability for claims between 2006 and 2008.
All four companies are featured in a cover story in today's issue of Modern Healthcare showing how declines in share prices of the four firms in 2011 have driven down the value of executive stock portfolios in the companies, including LHC Group CEO Keith Myers, whose portfolio of LHC stock has dropped in value by $29.9 million this year.