Home Health & Hospice Week

Look for stepped up audits and recoupments from the HHS Office of Inspector General.
In its Semiannual Report to Congress released Dec. 4, the OIG touts its "accomplishments" for the second half of fiscal year 2006. The OIG achieved a record $38.2 billion in Medicare savings and expected recoveries attributable to fraud, waste and abuse, it notes.

Home health agencies and suppliers of durable medical equipment, prosthetics, orthotics and supplies continued to be targets of efforts to identify fraud, waste and abuse, suggests the report.

Example: Lincare Holdings and its subsidiary Lincare Inc. agreed to pay $10 million to resolve allegations that Lincare paid illegal kickbacks and violated the Physician Self-Referral Law, the report notes (see Eli's HCW, Vol. XV, No. 19).

Out of providers' pockets: Of the $35.8 billion cut from Medicare spending in the fiscal year ending Sept. 30, $7.33 billion came from the restructuring of the home health payment system, according to the report.

Preventing unscrupulous providers from gaining Medicare certification and eliminating inappropriate incentives that increase cost and utilization were among the feds' targets within the home health industry. The agency also aimed to improve program controls, including eligibility determinations and approval of plans of care and services.

Note: The report is at http://oig.hhs.gov/w-new.html.