OIG Report Finds 22 Percent Error Rate in Home Health Agency Claims

On March 12, 2012, the Office of Inspector General of the U.S. Department of Health and Human Services (OIG) issued a report detailing its review of a sample of claims submitted by home health agencies (HHAs) in 2008. The report notes that the number of HHAs grew by 39 percent from 2002 to 2008, and Medicare spending on home health increased 84 percent between 2000 and 2007, leading to concerns regarding the potential for fraud and abuse. In light of these concerns, the OIG conducted a review of HHA claims submitted in calendar year 2008 for 489 Medicare beneficiaries. This review found that 22 percent of the reviewed claims were submitted in error because the services either were not medically necessary or were coded inaccurately, resulting in $432 million in improper Medicare payments.

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