Politics & policy

Insight into federal and state health care legislation & CMS regulation

New Home Health Caregivers Get OK From Medicare

The Department of Health and Human Services has lifted its moratorium on enrolling new home health agencies in the Medicare program.

President Clinton instituted the moratorium in September 1997 after government studies uncovered a pattern of fraud and abuse in the Medicare home health industry.

But in the last four months, the department has introduced a slew of antifraud measures, including a stiff requirement for surety bonds to protect consumers and a new payment system that creates incentives for agencies to provide more efficient care.

Watch for other antifraud proposals this year, including regulations requiring criminal background checks for home health aides and rules requiring home health agencies to re-enroll every three years, which will help Medicare check on quality and integrity and exclude problem providers.

Home health services are a $15 billion chunk of Medicare. About 10,000 home health care agencies were in the business, with more than 100 entering the field every month, when the moratorium was imposed.

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