Home Health, News

OIG report suggests CERT data could identify ‘high-risk’ home health agencies

A report from the Department of Health & Human Services (HHS) Office of Inspector General (OIG) recommends using Comprehensive Error Rate Testing Data (CERT) to identify “high-risk” home health agencies to help reduce improper payments and agency error rates.

CMS didn’t agree with the recommendation, however. Instead CMS points to CMS’ fraud prevention system, targeted probe and educate reviews and the Review Choice Demonstration as methods to reduce improper payment in home health.

According to the OIG report, in fiscal years 2014 through 2017, Medicare paid more than $4 billion to 87 agencies identified as high-risk.

Insufficient documentation was responsible for more than 90 percent of errors for agency claims in that time period, the report states.

Related link: View the report at https://bit.ly/2mjuPVk.