Soledad, CA: Home Health Services Spared From Medi-Cal Cuts: Fraud Reduced: View From A Private Duty
Soledad, CA: Home Health Services Spared From Medi-Cal Cuts: Fraud Reduced: View From A Private Duty Caregiver Serving Carmel, Carmel Valley, Carmel-by-the-Sea, Gilroy, Gonzalez, Greenfield, Hollister, King City, Marina, Monterey, Pacific Grove, Pebble Beach, Salinas, San Juan Bautista, Seaside And Soledad California
The federal government has more than tripled the amount of money it has recovered from efforts to stop Medicaid fraud in the past six years, USA Today reported after analyzing government records. That's good news for Medi-Cal recipients, who are facing an unprecedented assault on their benefits, as the state of California has tried to deal with a huge budget shortfall following the state legislature's refusal to put before voters a plan to extend temporary taxes which expired on June 30. The news story said that the government gained $573 million through fraud prosecutions in 2004, compared with $1.85 billion in 2010. This was spurred by a 57% increase in the amount of grant money given to state Medicare Fraud Control Units. "It's absolutely at the top of everyone's agenda. If done right, this is the way to reduce out of control expenditures," Matt Salo, executive director of the National Association of Medicare Providers, told USA Today. Many of the fraud cases have been extremely sickening, including an Atlanta doctor who was recently sent to prison for billing the elderly in nursing homes and even a number of dead former patients for services he did not provide. There has been good news and bad news on the Medi-Cal front this week, mostly bad unfortunately. The Department of Health Care Services (DHCS) on Thursday announced that the federal centers for Medicare & Medicaid Services (CMS) approved key elements of the state's 2011-2012 budget proposals to reduce Medi-Cal provider reimbursement rates. The approved cuts total $623 million including a 10% provider payment reduction on many outpatient services including physicians, clinics, optometrists, therapists, laboratories, dental, durable medical equipment and pharmacy; a new 10% provider payment reduction for freestanding nursing and adult subacute facilities; a 10% provider payment reduction and rate freeze for distinct part/nursing facility-B services. The good news was that CMS did not approve California's request to cut 10% payments to home health service providers, physician clinic services for children or distinct part subacute facilities. DHCS is still reviewing some long-term care services to determine if payments will be reduced. "We are providing California with requested flexibility to address their difficult budget circumstances while protecting the health care needs of California served by the Medicaid program...The state has submitted extensive data demonstrating that the remaining cuts will not jeopardize California's access to care, and has agreed to ongoing monitoring of access to care for affected services," said a CMS statement Family inHome Caregiving does not provide home health services but we work closely with a number of agencies that do, and it's extremely difficult for them to make ends meet when reimbursement rates keep going down but payroll, insurance and other overhead expenses keep going up.
http://www.usatoday.com/news/washington/story/2011-10-19/medicaid-fraud-money/50831614/1
About Richard Kuehn & Family inHome Caregiving of Monterey:
After more than a decade of caregiving, both in a professional environment and for a 97 year old family member I was dissatisfied with service from local caregiving agencies. I became convinced of the need for a service which provides very personal assistance to elderly and founded Family inHome Caregiving serving the Monterey Peninsula. Please visit my blog where I talk about important senior issues at:
http://www.familyinhomecaregiving.com/Blog
The federal government has more than tripled the amount of money it has recovered from efforts to stop Medicaid fraud in the past six years, USA Today reported after analyzing government records. That's good news for Medi-Cal recipients, who are facing an unprecedented assault on their benefits, as the state of California has tried to deal with a huge budget shortfall following the state legislature's refusal to put before voters a plan to extend temporary taxes which expired on June 30. The news story said that the government gained $573 million through fraud prosecutions in 2004, compared with $1.85 billion in 2010. This was spurred by a 57% increase in the amount of grant money given to state Medicare Fraud Control Units. "It's absolutely at the top of everyone's agenda. If done right, this is the way to reduce out of control expenditures," Matt Salo, executive director of the National Association of Medicare Providers, told USA Today. Many of the fraud cases have been extremely sickening, including an Atlanta doctor who was recently sent to prison for billing the elderly in nursing homes and even a number of dead former patients for services he did not provide. There has been good news and bad news on the Medi-Cal front this week, mostly bad unfortunately. The Department of Health Care Services (DHCS) on Thursday announced that the federal centers for Medicare & Medicaid Services (CMS) approved key elements of the state's 2011-2012 budget proposals to reduce Medi-Cal provider reimbursement rates. The approved cuts total $623 million including a 10% provider payment reduction on many outpatient services including physicians, clinics, optometrists, therapists, laboratories, dental, durable medical equipment and pharmacy; a new 10% provider payment reduction for freestanding nursing and adult subacute facilities; a 10% provider payment reduction and rate freeze for distinct part/nursing facility-B services. The good news was that CMS did not approve California's request to cut 10% payments to home health service providers, physician clinic services for children or distinct part subacute facilities. DHCS is still reviewing some long-term care services to determine if payments will be reduced. "We are providing California with requested flexibility to address their difficult budget circumstances while protecting the health care needs of California served by the Medicaid program...The state has submitted extensive data demonstrating that the remaining cuts will not jeopardize California's access to care, and has agreed to ongoing monitoring of access to care for affected services," said a CMS statement Family inHome Caregiving does not provide home health services but we work closely with a number of agencies that do, and it's extremely difficult for them to make ends meet when reimbursement rates keep going down but payroll, insurance and other overhead expenses keep going up.
http://www.usatoday.com/news/washington/story/2011-10-19/medicaid-fraud-money/50831614/1
About Richard Kuehn & Family inHome Caregiving of Monterey:
After more than a decade of caregiving, both in a professional environment and for a 97 year old family member I was dissatisfied with service from local caregiving agencies. I became convinced of the need for a service which provides very personal assistance to elderly and founded Family inHome Caregiving serving the Monterey Peninsula. Please visit my blog where I talk about important senior issues at:
http://www.familyinhomecaregiving.com/Blog
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