Home Health & Hospice Week

HHAs exceed pre-interim payment system levels.

Why is the OIG so gung ho on home health agency surety bonds? Here are the stats the HHS Office of Inspector General cites in justifying its call for enforcement of the surety bond requirement:

• Medicare spending on home health grew from $4 billion in 1990 to $18 billion in 1997. Spending went down after the Centers for Medicare & Medicaid Services put the interim and prospective payment systems in place in 1998 and 2000, but spending was back up to $19.3 billion by 2009.
• The number of HHAs also has exceeded pre-IPS highs, reaching nearly 11,500 in 2010.
• HHAs owed CMS $590 million in overpayments from 2007 to 2011, but repaid only $182 million of it.
• In the OIG's report covering 2007 to 2011, 414 HHAs each had outstanding overpayment amounts (excluding interest) of more than $50,000 in at least one year, totaling $341 million. Thirty-four HHAs each had outstanding overpayments of more than $50,000 for multiple years.
• One hundred thirty agencies had outstanding overpayments of more than $500,000. The highest amount owed for a single year was $16.4 million.
• In a recent report, the OIG estimates $432 million in improper HHA payments in 2012.
• The OIG regularly collaborates with the Department of Justice on multi-million-dollar Medicare home health fraud investigations.

Source: The OIG's Surety Bonds Remain an Unused Tool to Protect Medicare from Home Health Overpayments (OEI-03-12-00070), https://oig.hhs.gov/oei/reports/oei-03-12-00070.pdf.