In recent years, federal authorities have been cracking down on home health care fraud. In the DC Metro region, just three years ago 25 people were indicted on fraud charges, At the time it was heralded as a great step in the right directed toward cracking down on Medicaid fraud that was costing taxpayers billions of dollars nationwide annually.
Three years later, though, a recent audit has highlighted some serious issues that remain within the industry and intimates that there are still many issues that need to be addressed in order to keep this from happening over and over again.
According to the Washington Business Journal blog, Years after FBI raids for home care fraud, District auditor raises concern over Medicaid oversight, written by Tina Reed, Staff Reporter:
“The crackdown resulted in the termination of four home health care providers from D.C.’s Medicaid program after officials determined more than 80 percent of their billing was likely fraudulent. Two providers voluntarily left the program and three additional providers had their suspensions lifted but had restrictions placed on services they could provide.
The Office of the Inspector General made several recommendations for improving oversight, including improving enforcement of compliance by contractors and to implement procedures to conduct onsite audits or reviews of provider records to ensure future maintenance of complete and accurate records.”
At issue here is that the Department of Health Care Finance did not maintain adequate records of personal care aide services that were provided under the Medicaid program during 2014. This is one of the main reasons there were so many opportunities for people to defraud Medicaid services.
Home care support services has been generating a great deal of media attention in recent years as being the number one job creator in the country, but that it’s also grappling with low pay for caregivers and a host of other challenges.
It has long been a bastion for men and women who see some of the glaring problems of oversight and who aim to take advantage of the system. Without proper oversight and maintaining adequate records, it becomes too easy for some owners of these agencies to submit bills for services that were either not needed or provided.
As the push for more accountability continues, without adequate steps and action on the part of the government, investigators may continue fighting the same battle, and that is likely going to continue costing taxpayers billions, ultimately limited the care and support elderly and disabled Medicaid clients might receive.
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