Home Health & Hospice Week

CMS and its contractors slacking, federal watchdog claims. The Government Accountability Office wants Medicare to step up its claims reviews for home health agencies. HHA claims review is woefully inadequate, the GAO says in a follow-up letter to an April hearing by the Senate Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security. The April hearing focused on Medicare waste, fraud, and abuse. "In fiscal year 2007, only 0.5 percent of the more than 8.7 million home health agency claims processed were subjected to prepayment review," the GAO tells Subcommittee Chair Tom Carper (D-Del.) and Ranking Member John McCain (RAriz.) in the July 20 letter. "Of those claims that were reviewed, over 40 percent were denied in whole or in part." Bottom line: "The extent of errors found would suggest that both prepayment and postpayment medical reviews should be increased to more effectively avoid or recoup overpayments," [...]