Home Health, Hospice, News

OIG recommends changes for home health, hospice, personal care services to reduce fraud

In a July report, the Department of Health and Human Services Office of Inspector General (OIG) revisited its top 25 unimplemented recommendations for reducing fraud, waste and abuse. Several of the recommendations involve home health, hospice or personal care services.

The OIG recommends the implementation of a statutory mandate requiring surety bonds for home health agencies that enroll in Medicare. This requirement could be considered for other providers, too.

The report contends CMS could have recovered $39 million in uncollected overpayments between 2007 and 2011 if home health agencies had been required to have $50,000 surety bonds.

Another recommendation is for CMS to create “additional remedies” for hospices with poor performance.

The OIG explains that CMS’ “only recourse when a hospice is found to have serious deficiencies is to terminate the hospice from the Medicare program, which limits CMS’s ability to address performance problems. If CMS cannot effectively address hospices’ performance problems, it cannot effectively protect Medicare beneficiaries or the program.”

The report outlines more than a dozen additional recommendations for hospice.

Personal care services are also featured in the report, with the OIG recommending CMS require states to either enroll personal care services attendants as providers or require those attendants to register with state Medicaid agencies and assign each attendant a unique identifier.

Related link: View the OIG report and all the recommendations at http://bit.ly/2TtDpx7.