Medicare Official Gets Tough With Home Health Care Agencies

Alarmed by reports that home health care agencies improperly are turning away patients, Medicare’s top administrator warned Tuesday that such practices could lead to a firm being banned from the program.

“We’ve been hearing that some of the home health agencies have been trying to scare beneficiaries,” said Nancy-Ann Min DeParle, head of the Health Care Financing Administration. “They must not cut back the availability or quality of services to older Americans.”

DeParle’s comments at the American Association of Retired Persons’ annual national legislative council came after some members of Congress have complained that home health agencies have tried to scare clients into dropping coverage or have denied benefits to severely ill patients.

In a letter sent to home health agencies, DeParle notes that they are responsible for providing accurate information to patients and cannot reduce the amount of care ordered by physicians.

In addition, home health agencies are prohibited from discriminating against Medicare patients. If they accept non-Medicare patients with a certain severity of need, they must accept Medicare patients with the same level of need.

Medicare’s home health benefits had been growing about 25 percent a year from 1990 to 1996 - from $3.1 billion to $16.7 billion.

Last year, Congress decided to alter the payment method to a prospective payment system - similar to that used for hospital charges - rather than a reimbursement system. That change is scheduled to take effect late next year.