Healthcare Services Advisory

A recent U.S. Senate report provides home health care companies with some additional reasons to closely monitor their number of therapy visits to Medicare patients and the services they provide in those visits.

In a report it released on October 3, the Senate Committee on Finance said that in an investigation it determined that three large for-profit home health care companies provided what it called “medically-unnecessary patient care” with the goal of increasing their profits. Medicare Part A spends $19 billion a year for home health care, according to the report.

In its review of those companies’ internal documents, the Committee determined that they had their managers encourage therapists to meet a 10-visit target that would increase their payments from Medicare.

The Committee cited Amedisys Inc., Gentiva Health Services Inc. and LHC Group for that activity and for other practices that it said were designed to maximize Medicare reimbursements regardless of patients needs. It did not issue any penalties.

A principal recommendation of the report was that the Centers for Medicare and Medicated Services (CMS) “must move toward taking therapy out of the payment model.”

Following the release of the report, there is a prospect that the CMS will increase its scrutiny of home health care companies’ billings on patients for whom they perform 10 or more therapy visits during a year. In some cases, home health care companies might find it necessary to perform their own added due diligence to determine if visits meet CMS rules for being necessary.

If you would like additional information on the Senate Committee on Finance report or on the overall issue of monitoring the number of visits to Medicare patients, do not hesitate to contact our Healthcare Specialists or call us at 1-800-239-1474.