Wednesday, January 2, 2013

OIG Releases CMS and Contractor Oversight Report on Home Health Agencies


In 2010, Medicare paid $19.5 billion to 11,203 home health agencies for 3.4 million Medicare beneficiaries.  The OIG stated that home health agencies are considered to be particularly vulnerable to fraud, abuse, and waste.  The study collected information from CMS, Medicare Administrative Contractors (MAC) and Zone Program Integrity Contractors (ZPIC).  They found two of the MACs prevented $275 million in improper payments and referred 14 instances of potential fraud and 5 home health had their billing privileges revoked.

The OIG recommends that CMS establish additional contractor performance standards for high-risk providers in fraud-prone areas.  Develop a system to tract revocation recommendations and respond to them in a timely manner.  Follow up and prevent inappropriate payments made to HHAs with suspended or revoked billing privileges.

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If you have questions or need additional information please call Richard Dixon at
(321) 473-8561.

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