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Report – HHA’s and Hospices Are Billing Medicare Accurately

Report – HHA’s and Hospices Are Billing Medicare Accurately

Published by: Melissa C. - OMG, LLC. CEO on November 27, 2007

A recent report showed that HHA’s (home health agencies) and hospices are billing Medicare on an accurate level according to a report compiled by the CMS’ Comprehensive Error Rate Testing.

The report showed that HHAs had a 1.4 percent error rate and hospices a 1.0 percent error rate in the November CERT report, which covers claims from April 2006 to March 2007.

DME (durable medical equipment) suppliers had a wide range of error rates broken out by supplier type. The lowest was 0.6 percent for a medical supply company with prosthetic/orthotic personnel certified by an accrediting organization while the highest was a whopping 51 percent for “unknown supplier/provider” where it could not be ascertained exactly what the DME device was that was issued to the patient.

A summary of the CMS’ report showed that overall, the national error rate for Medicare was 3.9 percent. In terms of money this translates to $10.8 billion in improper payments, $1 billion of which were in the form of underpayments, according to the report. The good news is that this report shows that figure is down from 4.4 percent in the 2006-2007 report.

You may view this report online https://www.cms.hhs.gov/apps/er_report/preview_er_report.asp?from=public&which=long&reportID=7.

Published by: on November 27, 2007

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