Home healthcare, the fast-growingdestination for many individuals who previously might have soughtnursing home care, has been besieged by a spate of fraudulentMedicare reimbursement practices, government investigators say.Overstating a person’s healthcare needs – or upcoding – is asignificant problem, the government Accountability Office found.
In one example out of Houston, just 1out of every 11 beneficiary claims was properly coded, the GAO said.Other frequent problems included payoffs for doctor referrals andbilling for services that didn’t take place.
Medicare spending on home healthcarerose 44% from 2002 to 2006, hitting $13 billion. Over that same span,the number of beneficiaries using home health services rose just 17%(to 2.8 million).
The Centers for Medicare & MedicaidServices said it was considering some of the GAO’s recommendations,including revoking billing privileges for a broader range of claimsoffenders and requiring criminal background checks for employees.
