11 States Limited Home Health Access

The Office of Inspector General issued a letter to CMS concerning States that improperly restrict eligibility for Medicaid Mandatory Home Health Services.  In July of 2000, CMS released a State Medical Director letter summarizing it efforts to review Federal policies to ensure fulfillment of the Americans with Disabilities Act.  The letter stated that, although Medicare requires beneficiaries to be homebound to qualify for home health services, imposing a homebound requirement on Medicaid home health benefits violates Medicaid regulations related to “amount, duration, and scope of services.  In July of 2011, CMS published a Notice of Proposed Rulemaking that would review Medicaid regulations to clarify that home health services cannot be restricted to individuals who are homebound or to services furnish in the home.  This rule has not been published in final form as of this date. The eleven states that the OIG listed as violating parts of this requirement are Alabama, Arkansas, Indiana, Montana, Nebraska, New Mexico, North Dakota, Pennsylvania, South Dakota, Utah, and West Virginia.

For more information please utilize the link below:

http://oig.hhs.gov/oei/reports/oei-07-13-00060.pdf