Home Health Care News: Despite $5.32B Decrease, CMS Likely to Keep Foot on Improper Payments Gas Ped

Updated: Dec 16, 2019

home health improper payment rates

Our co-founder and co-CEO, Tom Maxwell, was recently quoted in a Home Health Care News Article about improper payment rates. Check out an excerpt below.


The Medicare fee-for-service improper payment rate has fallen once again, thanks largely to the cleaner paperwork and ongoing compliance efforts of U.S. home health providers.

Despite clear and steady progress in bringing improper payment rates down, though, the Centers for Medicare & Medicaid Services (CMS) is unlikely to relax its oversight anytime soon, industry leaders say. Generally, improper payments are any over- or under-payments to Medicare-reimbursed providers that did not meet full statutory or regulatory requirements.

Total Medicare improper payments fell to an estimated $28.9 billion in 2019, CMS announced Monday. While a seemingly huge figure, that total only makes up about 7.25% of all Medicare fee-for-service claims.

Comparatively, 2019 improper payment levels were the lowest since 2010.

Last year, CMS flagged more than $31.6 billion in improper payments to Medicare providers, which often receive them due to unintentional documentation mistakes or misunderstandings — not intentional fraud schemes.

Find the rest of this Home Health Care News article by Robert Holly, here.

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