High-Risk, Error-Prone HHA Providers Using HHA Historical Data

For Calendar Year 2016, Medicare paid home health agencies (HHAs) about $18.2 billion for home health services. CMS's Comprehensive Error Rate Testing (CERT) program determined that the 2016 improper payment error rate for home health claims was 42 percent, or about $7.7 billion. Using data from the CERT program, we will identify the common characteristics of "at risk" HHA providers that could be used to target pre- and post-payment review of claims.

Announced or Revised	Agency	Title	Component	Report Number(s)	Expected Issue Date (FY)
Completed	Centers for Medicare & Medicaid Services	High-Risk, Error-Prone HHA Providers Using HHA Historical Data	Office of Audit Services	A-05-17-00035; W-00-17-35800;	2019