Filed Under:Health Insurance, Ltci

Investigators eye more Medicaid home health providers

The GAO studied 2,742 Medicaid fraud unit referrals.
The GAO studied 2,742 Medicaid fraud unit referrals.

Home health care providers now top the Medicaid fraud unit referral rankings.

Officials at the U.S. Government Accountability Office (GAO) have published fraud referral increase data in a report on fraud in the Medicare, Medicaid and Children's Health Insurance Plan (CHIP) programs.

The GAO found that the number of Medicaid home health fraud referrals increased to 730 in 2010, from 357 in 2005.

Home health accounted for about 27 percent of Medicaid fraud referrals in 2010. It rose to the top of the referral rankings that year, from third in 2005.

The number of health care practitioners referred for action fell to 406, from 487, and the share of referrals relating to practitioners fell to 15 percent, from 22 percent.

Similarly, the number of referrals involving hospitals fell to 103, from 113, and the share relating to hospitals fell to 3.8 percent, from 5.2 percent.

Referrals involving drug manufacturers jumped to 296, from 71.

Referrals involving insurance companies amounted to only about 1 percent of the total, officials said.

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Nichole Morford

Nichole Morford
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