Medicare Home Health Agencies:

Certification Process Is Ineffective in Excluding Problem Agencies

T-HEHS-97-180: Published: Jul 28, 1997. Publicly Released: Jul 28, 1997.

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Pursuant to a congressional request, GAO discussed how Medicare: (1) controls the entry of home health agencies (HHA) into the Medicare Program; and (2) ensures that HHAs in the program comply with Medicare's conditions of participation and associated standards.

GAO noted that: (1) it is finding that Medicare's survey and certification process imposes few requirements on HHAs seeking to serve Medicare patients and bill the Medicare program; (2) the certification of an HHA as a Medicare provider is based on an initial survey that takes place so soon after the agency begins operating that there is little assurance that the HHA is providing or capable of providing quality care; and (3) moreover, once certified, HHAs are unlikely to be terminated from the program or otherwise penalized, even when they have been repeatedly cited for not meeting Medicare's conditions of participation and for providing substandard care.

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