Medicare overpaying underperforming nursing homes $5.1 billion

Boston, MA 03/01/2013 (wallstreetpr) – U.S government investigators said that Medicare had paid $5.1 billion to various nursing homes that had not met the quality-of-care requirements. Inspector General of the Department of Health and Human Services stated in a report that reviewers found services related to medication and wound management to be sub-standard and the quality of overall care, poor. This, in addition to a separate report from last year showing that Medicare had paid an excess of $1.5 billion to nursing homes that they owed to in 2009. This because a quarter of the claims from the facilities had been billed erroneously.

Doubts being raised

All these findings are very disturbing and have raised serious doubts about the credibility of Medicare and their levels of integrity as far as payments are concerned. Medicare is the American health program for the disabled and elderly and it had paid $32.2 Billion to nursing homes in the financial year ending 2012. The inspector general made strong recommendations to the Centers for Medicare and Medicaid Services to intensify surveillance of nursing facilities that are under-performing and to strengthen all regulations related to care planning.

Marilyn Tavenner, the CMS administrator seconded the recommendations. Greg Christ, an American Health Care association spokesperson said that nursing homes need to be able to make changes to their care plans on a regular basis as the needs of people who use nursing home services change daily as well. He said that caregivers are being more adaptive and that health outcomes are helping in improving the condition of patients.

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Published by Steve Hackney

Steve Hackney is a corporate finance professional with over 14 years of experience in cash management and investing. He earned a Bachelor of Science in Finance from Florida State University and holds a Certified Treasury Professional certification. Steve lives in Orlando, Florida with his family.