Home Health & Hospice Week

Medicaid home care services have been on the HHS Office of Inspector General’s hit list for a while, but now they are officially added to the watchdog agency’s Work Plan.

The OIG will issue a report on “Medicaid Personal Care Services” next year, the agency says in its latest Work Plan update. “Prior OIG reviews identified significant problems with States’ compliance with PCS requirements,” the OIG says. “Some reviews also showed that program safeguards intended to ensure medical necessity, patient safety, and quality, and prevent improper payments were often ineffective.”

What’s ahead: “We will determine whether improvements have been made to the oversight and monitoring of PCS and whether those improvements have reduced the number of PCS claims not in compliance with Federal and State requirements,” the OIG vows.

Do this: In light of the new Work Plan item, “home health agencies providing Medicaid PCS services should ensure all state qualification and documentation requirements are met in addition to Federal requirements,” urges the National Association for Home Care & Hospice. And home health and hospice agencies “providing Medicare services to beneficiaries who are also receiving Medicaid PCS services (either by the same … or another agency), should ensure that all services required under Medicare are being provided.” That particularly goes for aide services, NAHC says in its member newsletter.

The Work Plan item is at https://oig.hhs.gov/reports-and-publications/workplan/summary/wp-summary-0000368.asp.