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.
For
more information please utilize the following link
If you have questions
or need additional information please call Richard Dixon at
(321) 473-8561.
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