A U.S. Senate Finance Committee report says two publicly traded Louisiana home health companies encouraged therapists to make the most profitable number of patient visits, even when the patients’ needs may not have justified the treatments.
The committee named Baton Rouge-based Amedisys Inc., Lafayette-based LHC Group Inc., and Atlanta-based Gentiva.
Each company showed concentrated numbers of therapy visits at or just above the point at which a “bonus” payment was triggered in the Medicare payment system, according to the report. The bonus payment was worth hundreds of dollars per patient.
Amedisys’ records showed that prior to 2008, managers were encouraged to meet the 10-visit threshold, resulting in a bonus for the company, the report says. After the Centers for Medicare & Medicaid Services changed the number of visits needed to collect the bonus, Amedisys adjusted its programs to target the most profitable treatment patterns.
In addition, Amedisys pressured therapists and regional managers to adhere to new clinical guidelines developed to maximize Medicare reimbursements.
Top LHC Group managers, including Chief Executive Officer Keith Myers, instructed employees to increase the number of therapy visits, which allowed the company to increase revenue. In general, Medicare payments are higher for sicker patients, who require more treatment.
Amedisys issued a statement saying the company was pleased that the committee had finished its investigation but disappointed with the conclusions.
Amedisys stands by its integrity, ethics and patient care practices, the company said.
On Friday, LHC agreed to pay $65 million to the federal government to settle an unrelated whistleblower case. In that case, the U.S. Justice Department alleged that LHC charged Medicare for services that weren’t medically necessary and that the company treated patients at home who could have gone to doctors’ offices.
LHC didn’t admit any wrongdoing in the settlement.