Preventing Medicare Fraud from Crumbling the Future of Home Health Care

Dec 13, 2016 7:27:09 AM

As we look back on some of the key stories of 2016 for home care agencies, one leaps out repeatedly: Medicare fraud.

crumbling-dollar.jpgWe previously wrote about the Medicare Fraud Strike Force executing the largest sting on fraudulent billings in its history: 301 people were charged in alleged fraudulent billings of more than $900 million. We also wrote about how the increase in fraud is driving payers’ demand for electronic visit verification.

In the report “The Future of Home Health Care: A Strategic Framework for Optimizing Value,” published in the peer-reviewed journal Home Health Care Management and Practice, a team of researchers identified fraud as one of the top three obstacles for home health agencies to overcome in the future.

How can you keep fraud from crumbling your business?

To help prevent Medicare fraud, home care and services delivery agencies need to find ways to:

  • Provide proof of visits and services delivered
  • Enable staff and regulators to respond to audits faster and easier 

A Care Delivery Management solution can help address both points. For example, Hospice at Home, an affiliate of nationally recognized Lakeland Health, improved management oversight of visit verification and compliance by using CellTrak’s Operations Team Portal. Because field workers could easily and immediately check in on a mobile device, visit verification compliance more than doubled in just six months. Additionally, record completion and accuracy improved because care documentation was happening on the spot.

When agencies can demonstrate thorough, accurate records in a secure electronic format, it shows they are serious about compliance. As we’ve all heard, an ounce of prevention is worth a pound of cure.

But more than that, having trusted documentation in readily accessible digital reports can greatly improve an agency’s ability to respond to an audit.

As stated in “The Future of Home Health Care” report, “Program integrity and fraud should be addressed in a targeted fashion, directed toward fraud ‘hot spot’ areas … Removing the albatross of fraud in home health care will enable greater confidence in using Medicare home health by multiple stakeholders in the future.”

Learn more about how technology can reduce the risk of fraud and help your agency prepare for and respond to audits. Download "14 Ways a Complete Mobile Health Care Deliver Management Solution Helps Your Bottom Line."


Topics: Fraud, Compliance, Productivity