Reliance on Unverified Patient Lists Creates a Vulnerability in Home Health Surveys

Home health is a program area susceptible to fraud, waste, and abuse. To ensure that home health agencies (HHAs) comply with Medicare standards, Medicare requires them to undergo onsite surveys conducted by State survey agencies or accrediting organizations prior to initial enrollment and at least once every 36 months thereafter. As part of this process, however, surveyors use HHA supplied lists to select patients for review, prompting concern that HHAs could manipulate these lists to avoid scrutiny of certain patients.