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Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review Of Home Health Agency Costs Claimed By Niagara County Health Department For Calendar Year 1997," (A-02-98-01040)

December 1, 1999


Complete Text of Report is available in PDF format (1.26 MB). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.

EXECUTIVE SUMMARY:

We estimate that, of the $2.5 million claimed by NCHD for calendar year (CY) 1997, at least $807,679 was for services which did not meet Medicare guidelines. Using the 90 percent confidence interval, we believe the overpayment is between $507,679 and S 1,358,3 19. We found that 70 of 100 home health claims reviewed, containing 780 of 1,562 services, were not reimbursable under Medicare. The 750 services were found to be unallowable for the following reasons: