Fraudulent billings increase Medicare’s spending on home health services

The Friday report from the Government Accountability Office (GAO) highlight that during the five-year period, 2002-2006, the Medicare spending on home health services marked a 44 percent increase largely due to fraudulent billings by the company.

Having reviewed the home care payments for the period, the GAO reported that Medicare’s spending had reached $13 billion in 2006. In the same period, the 2.8 million enrolments for Medicare in-home services also marked an increase of 17%.

The report drew attention to fraud and abuse by Medicare, saying that while a few home care providers overstated the medical conditions of the patients in order to receive higher payments, other home health companies charged Medicare for superfluous services or care.

One of the foremost Republicans on the Senate Finance Committee, the Iowa Sen. Chuck Grassley, said that there is need for bracing up of supervision by Medicare. He said: “There’s no excuse for Medicare officials neglecting payment problems.”

As per the recommendations of the GAO study, the Centers for Medicare & Medicaid Services (CMS) should carry out criminal background checks on home health operators, and frame newer rules for eliminating the problem providers.

Commenting on the increase in Medicare spending, William Dombi – VP for law at the National Association for Home Care & Hospice – said that experience shows that “that kind of growth usually indicates something is wrong.”

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