HHS Inspector General: Medicare paying over cost

Nancy Marshall-Genzer Sep 30, 2015
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HHS Inspector General: Medicare paying over cost

Nancy Marshall-Genzer Sep 30, 2015
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The inspector general of the Department of Health and Human Services has released a report on Medicare payments to nursing homes. 

The report says Medicare is paying above-cost for physical therapy — paying more for the therapy than it costs nursing homes to provide — and it does not mince words.

“Medicare payments for therapy greatly exceeded nursing homes’ costs for therapy,” says Jodi Nudelman, one of the report’s authors.

Nudelman says if Medicare paid a nursing home $100 for physical therapy, $29 of that would be extra, over what the care actually cost. And Nudelman says some care wasn’t needed or wanted.     

“Beneficiaries were receiving therapy that was not  reasonable or necessary, or facilities were billing for therapy, but not providing therapy,” she says. 

Greg Crist is spokesman for the American Health Care Association, a nursing home trade group. He says the care is needed.

“The therapy that’s being offered is more than welcomed by the patients and the individuals to help them improve, and return home,” he says.

But Crist says the payment system should be restructured, to focus more on outcomes.

 

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