Medicare pays $5 million in “questionable” home health claims, OIG study finds

About $5 million in Medicare payments to home health agencies in 2010 went to claims that were later found to be suspect, according to a report released by the Office of Inspector General (OIG) this week.

The three most common claims errors were “overlapping with claims for inpatient hospital stays, overlapping with claims for skilled nursing facility stays, or billing for services on dates after beneficiaries’ deaths,” according to the report.

Eight states—California, Florida, Lousiana, Ohio, Oklahoma, Texas and Utah—had more than twice the national average of questionable claims. Two states—Florida and Texas—topped the offenders’ list with more than four times the national average. These two states also have more home health agencies, by far, than any other state in the country.

The OIG recommended closer monitoring of home health service billing, greater enforcement of the 10 percent cap on annual payments, and limitations on new home healthcare agency enrollments, especially in Texas and Florida.

Read the full OIG report.

Topics: Executive Leadership , Medicare/Medicaid , Regulatory Compliance