What day is National Report Long Term Acute Care Hospital Fraud Day celebrated? October 2
What is National Report Long Term Acute Care Hospital Fraud Day? National Report Long Term Acute Care Hospital Fraud Day not only brings awareness to the amount of Medicare fraud but provides the public with detailed steps for reporting Long Term Care Fraud (LTCH or LTACH fraud). Medicare fraud affects us all. Ten percent of all Medicare funds are lost due to fraud. Because the government spends $650 billion a year on Medicare, $65 billion a year is lost to Medicare fraud. It’s no wonder why we have a national healthcare crisis! It’s time the public stands up and puts an end to LTCH or LTACH fraud by long term acute care hospitals.
Who created this day? National Report Long Term Acute Care Hospital Fraud Day started in 2017. It was formed by The Hesch Firm, LLC after founding attorney, Joel D. Hesch, left government practice to help whistleblowers file for rewards. Mr. Hesch had devoted over 15 years working in Department of Justice whistleblower reward office where he helped obtain $1.5 billion in recoveries back for the government from those cheating Medicare. In the process, Mr. Hesch helped the government pay out hundreds of millions in rewards to whistleblowers. Mr. Hesch formed his own law firm and now exclusively represents whistleblowers nationwide in filing for rewards for reporting fraud against the government, including Long Term Care Fraud (LTCH fraud). Mr. Hesch has helped other whistleblowers obtain significant rewards for reporting LTCH fraud (or LTACH fraud). To help whistleblowers properly report LTCH fraud, he authored a free e-book on reporting Medicare fraud, and created a website to ensure that the public knows how to properly report LTCH fraud and follow the steps necessary to be eligible for a reward. Visit the website: www.HowToReportFraud.com.
How to celebrate: Celebrate National Report Long Term Acute Care Hospital Fraud Day by visiting Mr. Hesch’s website or by downloading his free Medicare fraud free e-book so that you understand the various LTCH fraud and other Medicare fraud schemes, as well as the Department of Justice whistleblower reward program. The website and book explains the benefits and risks of reporting fraud and the various ways you can report LTCH fraud. If you have the right type of information, you can and should report LTCH Medicare fraud.
How to report Medicare Fraud and received a monetary reward: There are two very different ways of reporting Medicare fraud, with two very different results. One is to report Long Term Care Fraud under the Department of Justice (DOJ) reward program, which pays whistleblower rewards of up to 25% of the amount DOJ recovers. The average DOJ reward for reporting Medicare fraud is $690,000 and some rewards have been as high as $150 million! In addition, if you Medicare report fraud under the DOJ program, the government must open an investigation and inform you of the results. Thus, applying for a reward is the only way to ensure an investigation takes place (rather than just calling a hotline). Today, over three-fourths of the government’s Medicare fraud cases are DOJ whistleblower reward cases. Thus, the government is counting on whistleblowers to report Long Term Care Fraud to DOJ and receive a reward in the process.
The other way to report LTCH Medicare fraud is to report fraud directly to the Centers for Medicare & Medicaid Services (CMS), which runs the Medicare program. The downside by reporting the LTCH fraud to CMS is that the reward is limited to $1,000 rather than the DOJ program that pays up to 25% with no limit or cap. You can report fraud directly to CMS through its website or by calling its hotline.
Here is a link to the CMS website: https://oig.hhs.gov/fraud/report-fraud/index.asp.
Here the CMS hotline: 1-800-MEDICARE (1-800-633-4227).
It’s time to put an end to fraudulent LTCH Medicare claims! For more details, simply visit Mr. Hesch’s website or read his free e-book, which provides step-by-step instructions for reporting Long Term Care Fraud. It is your one resource for all you need to know about reporting LTCH Medicare fraud and obtaining a whistleblower reward.
Overview of Long Term Acute Care Hospital fraud (LTCH) Fraud
During 2002, Medicare began paying long term acute care hospitals (LTCH or LTACH) on a prospective payment system (PPS), which is called LTACH-PPS. Under LTACH-PPS, Medicare pays a fixed or set price to long-term acute care hospitals. Because patients staying long term at a hospital can cost more than the stay for patients at general hospitals, Medicare pays a higher rate to LTACH’s, provided they meet the requirements of being a long-term acute care hospital. Specifically, the LTACH must have an average inpatient length of stay for Medicare patients greater than 25 days. LTACHs that fail to exceed the 25-day rule for Medicare patients must repay Medicare the higher rates. This can mean millions of dollars.
LTACH Fraud: Extending Stays
Many long-term acute care hospitals engage in fraud schemes to make it appear that they meet the 25-day average stay when they really do not. For instance, they keep many patients longer than medically necessary just to pad their numbers of days. In other words, administrators purposefully delay in creating discharge plans. They may even lie to family members, claiming the doctor wants them to stay a few more days. They also delay in contacting nursing homes or hospice facilities where the patient is supposed to go just to keep them longer in their hospital.
LTACH Fraud: Interrupted Stays
Other long term care hospitals engage in fraud schemes to bill more costs to Medicare by circumventing the “interrupted stay” regulation, which does not pay LTACH’s more funds if they discharge patients for less than 10 days before readmitting them. The purpose of this rule is to prevent a LTACH from transferring a patient to another provider just to bring them back so they can bill more. For instance, suppose Jane Doe is admitted to LTACH for an illness that she is expected to be in the hospital for 30 days. (Note: a LTACH does not get paid for days after the allowed length of stay. But if after 10 days away, it can readmit the patient and keep billing.) If on day 28, Jane develops a condition requiring intensive care, she is properly transferred to an ICU hospital. Assume Jane gets better in 8 days and should go back to the LTACH. But, the LTACH will not get paid more if she returns in less than 10 days, so the LTACH blocks the admission by stalling and refusing to allow the patient to be transferred back until 10 days passed. This is fraud, and the LTACH must repay the extra billing submitted to Medicare.
Free E-Book for reporting Medicare fraud. To help whistleblowers properly report Long Term Care Fraud (or any Medicare fraud), Mr. Hesch authored a free free e-book on obtaining rewards for reporting fraud against the government. You can also go directly to Mr. Hesch’s website to start the process of filing for a whistleblower reward (www.HowToReportFraud.com).