Medicare Fraud and Abuse

Medicare Abuse with Home Health Care Services

Health care at home is on the rise replacing expensive hospital visitations and stays. Instead, the home care services comes to the patient at their own location.  Care can be provided in a private home or at an assisted living community.  The licensed home health care agency gets reimbursed by Medicare. This substitution holds lots of benefits for both the patient and the country as it has potential to save billions every year as well as keeping hospitals rooms open. The leading company in right now in the field of home visits is Amedisys and they derive 90% of their revenue from Medicare abuse.

 

Throughout the years, Medicare is working on providing safeguards to prevent Medicare Fraud and Abuse.  This type of practice of course carries with it questions and concerns. With home visits, there is little supervision over these companies and doctors, as well as few overlying rules to account for pricing and charges. With no one keeping a close eye on the each and every check up like it is done in a hospital, it is hard to tell if the patients are getting exactly what they need, or if they are even getting what it is said they are getting. It is hard to tell if their treatment is the full package, or are they getting shorthanded.

I have to say, in the way our society is currently set up, this is quite the tricky situation to deal with. It’s true without someone coherent in medial terminology supervising each and every check up, there is no way to ensure that things are being done in a proper way or that the truth is being told. The best measures to prevent Medicare fraud would essentially be company check ins along with surprise surveillance at appointments to ensure everything that they say is being done is being done.

If and when a physician is found “distorting” the situation, both he and the company should be held accountable. This will help ensure stricter guidelines are in place when hiring, which is step one in assuring quality assistance and no Medicare fraud.

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