Duplicate Payments for Home Health Services Covered Under Medicare and Medicaid
Medicare Home Health Agency (HHA) coverage requirements state that an HHA is responsible for providing all services either directly or under arrangement while a beneficiary is under a home health plan of care authorized by a physician. Consequently, Medicare pays a single HHA overseeing that plan. "Dual eligible beneficiaries" generally describes beneficiaries eligible for both Medicare and Medicaid. Medicare pays covered medical services first for dual eligible beneficiaries because Medicaid is generally the payer of last resort. We will determine whether States made Medicaid payments for home health services for dual eligible beneficiaries who are also covered under Medicare.
|Announced or Revised||Agency||Title||Component||Report Number(s)||Expected Issue Date (FY)|
|January 2019||Centers for Medicare & Medicaid Services||Duplicate Payments for Home Health Services Covered Under Medicare and Medicaid||Office of Audit Services||W-00-19-31141||2020|