A Foolproof Solution to Home Health’s Billion-Dollar Fraud Problem
Proof of presence
A senior population that is the fastest-growing sector in the U.S., along with combined Medicaid and Medicare reimbursements for home-based care in excess of $31 billion, has created a booming home health industry that is expected to reach a value of $150.8 billion by 2018. Big-dollar payments and explosive growth have combined to create yet another highly lucrative industry: reimbursement fraud. This has led a number of states to take the unusual step of requiring home-health care providers to implement electronic visitor verification (EVV) systems as a condition of Medicaid participation. These systems hold great promise for putting an end to fraud by providing an indisputable “proof of presence” of the home-health aide or nurse in the patient’s home.
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