Michigan-based home health care business overbilled by $10.5 million, U.S. audit shows

Great Lakes Caring

Great Lakes Caring, 900 N. Cooper St. in Jackson, is under a review for potentially overbilling Medicare.

JACKSON, MI – A federal review of Jackson-based Great Lakes Home Health Services estimates the company incorrectly billed Medicare for more than $10.5 million between 2014-15.

An audit from the Office of the Inspector General within the U.S. Department of Health an Human Services was released in May, saying Great Lakes incorrectly billed Medicare for beneficiaries who weren't homebound or did not require skilled services.

The audit in under review by the Centers for Medicare and Medicaid Services, CMS spokeswoman Liz Schinderle said. It will likely take months before CMS decides if it will recoup overpayments from Great Lakes.

OIG could also impose penalties, although none were suggested in the audit, OIG spokesman Don White said. To see the full 50-plus page report, click here.

Great Lakes provides home health and hospice care throughout the Midwest and Northeast and has 11 locations in Michigan. It was named one of the best health care employers in the U.S. in 2017.

The company disputes the audit findings, according to the report. The OIG did not apply Medicare requirements correctly – among other issues – Great Lakes said in its written response inside the report. Company officials declined to comment further on the issue.

OIG reviewed 100 Great Lakes claims from 2014-15 through a stratified random sample, totaling $341,000. It determined 38 claims were incorrectly billed for more than $64,000. Taking into account Medicare’s $69.7 million in claims payments to Great Lakes in 2014-15, OIG estimated the company overbilled Medicare by $10.5 million.

"These errors occurred primarily because Great Lakes did not have adequate controls to prevent the incorrect billing of Medicare claims within selected risk areas," the report states.

The OIG is finding that error rates like this are fairly common among such companies, White said.

“Obviously this specific report was looking at Great Lakes, but in general, home health agencies have had a very high claims error rate,” he said.

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