Medicaid:
OVERLAPPING HOME CARE SERVICES COULD MEAN MEDICAID OVERPAYS
Published on Tue Jan 13, 2009
New OIG report should be a 'wake-up call' for HHAs, trade group warns. If you're confused about exactly which aide and nursing services Medicare covers versus Medicaid, you're not alone -- it seems the feds are a bit fuzzy on the concept too. Out of $3.3 million in aide and nursing services the HHS Office of Inspector General reviewed for a new report, the OIG deemed $2 million as "vulnerable" to inappropriate payment by Medicaid. In counting at-risk payments for aides and nurses, the OIG counted any Medicaid-paid visits that occurred during a Medicare PPS episode and that were part time or intermittent. Without a detailed medical review, the OIG couldn't determine if the visits were actually incorrectly paid by Medicaid or not,the agency admitted. Pitfall:Acommon mistake home health agencies make is to bill Medicaid for a visit when a nurse performs a service that Medicare doesn't cover, like administering eye [...]