Home Health & Hospice Week

Surety bonds, improper payment rate catch watchdog agency's attention.

Don't expect oversight from the feds to let up any time soon. So indicates the HHS Office of Inspector General's new report on "Top Management and Performance Challenges."

The number-one listed challenge for the OIG is ensuring program integrity in Medicare. That includes reducing improper payment rates and combating fraud. "Program areas susceptible to widespread fraud include home health, hospice services, DME, ambulance transportation, and clinical laboratory testing," the OIG says in the report. In another section of the report, the OIG says home health and chiropractor services "have extremely high rates of improper payments."

In fact, home health fraud gets its own separate highlight box in the report. "The Medicare home health benefit has long been recognized as vulnerable to fraud, waste, and abuse," the OIG maintains. "Home health care represents a significant component of Medicare expenditures. In 2016, Medicare paid for more than 11,000 home health services, totaling approximately $18.24 billion."

Ahead: Home health features in the report's section on reducing improper payments too. "In FY 2018, OIG will prioritize work that identifies ways the Department can reduce improper payments for home health by reducing Medicare spending in geographic 'hot spots,'" the watchdog agency says in the report.

The OIG also points out that the Centers for Medicare & Medicaid Services has failed to implement HHA surety bonds, as it is authorized to do. "CMS should implement the requirement for home health agencies to obtain surety bonds to ensure that Medicare can recoup at least some of its overpayments and to potentially deter ill-intended providers," the agency urges.