Medicaid Health Homes Catch Eye of Health-Care Watchdog


 

While no one in health-care relishes the thought of a government review, they are as inevitable as death and taxes, and Medicaid’s health homes program is the latest victim. A recent update from the Health and Human Services Office of Inspector General announced an upcoming review of the health homes program, with a report to be issued by fiscal year 2019.

States participating in the health homes program receive higher federal Medicaid payments for the first eight quarters of their existence, and the review will focus on how the funding is being used and whether the states are in compliance with federal and state requirements.

The OIG’s audit will likely be informed by past experiences with some of the problems associated with Medicaid’s home-care services, Ellyn Sternfield, a health-care attorney with Mintz, Cohn, Ferris, Glovsky and Popeo PC in Washington, told me.

Traditional Medicaid home-health services have been plagued by hundreds of fraud cases every year, Sternfield said, and the OIG review of the health homes program will want to make sure those problems aren’t replicated in the new program.

The health homes program was created by the Affordable Care Act and helps beneficiaries with chronic conditions coordinate their care. Health homes providers coordinate a patient’s primary, acute, behavioral health, and long-term care.

As of May, 21 states and the District of Columbia have established health homes programs, with over 1 million beneficiaries enrolled.

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