Medicare: Increased Denials of Home Health Claims During 1986 and 1987
HRD-90-14BR
Published: Jan 24, 1990. Publicly Released: Jan 24, 1990.
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Highlights
Pursuant to a congressional request, GAO reviewed increases in Medicare home health care claim denials during 1986 and 1987, focusing on: (1) reasons for the increased denials; (2) the extent that denial rates varied among regions and the causes of those variances; (3) how many home care agencies lost their liability waivers; and (4) how increased denials have affected the appeals process.
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Administrative costsAppeals processClaims processingClaims reconsiderationsClaims settlementElderly personsEligibility determinationsHome health care servicesLiability (legal)MedicareReorganizationRisk management