Home Health & Hospice Week

Exactly how far still unclear.

Home health agencies are looking less and less like the bad guys every year — including this one.

“The Medicare Fee-For-Service (FFS) improper payment rate has continued to decline,” the Centers for Medicare & Medicaid Services says in a Nov. 17 press release. “Home health improvements, including clarifying documentation requirements and educating providers through the Targeted Probe and Educate program, resulted in a $5.9 billion decrease in estimated improper payments from FY 2016 to FY 2020,” CMS says.

CMS did not release the home health improper payment rate itself, though. Representatives for the agency did not respond to AAPC inquiries about this year’s rate by press time.

Last year’s improper payment rate for home health claims was 12.1 percent, down from a whopping 59 percent for 2015; 42 percent for 2016; 32 percent for 2017; and a much lower 17.6 percent for 2018 (see Eli’s HCW, Vol. XXIX, No. 1).

Overall, the entire Medicare FFS improper payment rate was 6.27 percent in 2020, down from 7.25 percent last year, CMS says in a fact sheet.