Accession Number:

ADA109459

Title:

Medicare Home Health Services: A Difficult Program to Control

Descriptive Note:

Corporate Author:

GENERAL ACCOUNTING OFFICE WASHINGTON DC HUMAN RESOURCES DIV

Personal Author(s):

Report Date:

1981-09-25

Pagination or Media Count:

67.0

Abstract:

A GAO review at 37 home health agencies revealed that 27 percent of the visits reviewed that were made to a sample of beneficiaries were not covered under the Medicare program or their coverage status was questionable. Claims processing systems generally failed to detect the noncovered care and GAO attributed this to the lack of information on which to base an informed judgment. Determining whether beneficiaries were homebound was difficult. GAO found the homebound criteria to contain key undefined terms requiring the use of ones own judgment. Finally, GAO found that the use of aide services to assist beneficiaries with personal care could be substantially reduced because either the beneficiary or family and friends often could and would have provided the care required. Author

Subject Categories:

  • Government and Political Science
  • Medicine and Medical Research

Distribution Statement:

APPROVED FOR PUBLIC RELEASE