OIG: Home health has 'limited' oversight, reporting

Tools

Home health agencies are not meeting all federal reporting requirements and have "limited" oversight from the Centers for Medicare & Medicaid Services, the Office of the Inspector General said in its Monday report. Home health agencies did not submit required Outcome and Assessment Information Set (OASIS) data for 6 percent of the claims in 2009, which represented more than $1 billion in Medicare payments. They also submitted 15 percent of OASIS data sets late. CMS only penalized about 200 home health agencies with the 2-percent payment reduction from 2007 through 2010, the OIG noted.

The OIG recommended that CMS identify all home health agencies that failed to submit OASIS data and apply the 2-percent payment reduction to them, with which CMS agreed. The OIG also recommended establishing and implementing enforcement actions for agencies that submit OASIS data after the 30-day deadline, as well as developing clear guidelines that delineate expectations for states regarding timely and accurate OASIS data, both of which CMS did not concur.

The FBI on Monday identified home health agencies, among other health sectors, as an area of concern for fraud. OIG announcement