- Associated Press - Monday, December 15, 2014

COLUMBUS, Ohio (AP) - Ohio’s regulation of the booming home health care industry is fragmented, behind the times and often ineffective, a paper’s investigation has found.

At issue is a nationwide shift away from nursing homes and institutions and a big increase in the number of workers going into the homes of ill, disabled and elderly Ohioans, according to an investigation by the Columbus Dispatch in a series that began Sunday (https://bit.ly/1wSnJ8r ).

Home health care fraud includes questionable billing practices and multiple criminal convictions, including many in central Ohio, with most of home health care provided by poorly paid aides with limited training and high rates of turnover, according to the report.

The paper also says consumers have few reliable ways to evaluate home health care agencies.

Home-care agencies are everywhere, said Mary Muchene, owner of Divine Home Health Care in Columbus.

“And most people are doing it for the wrong reasons,” she said. “It’s so easy to open up one of these places in Ohio.”

Among the paper’s findings:

- Since 2003, the home health care industry has grown by 92 percent in Ohio, one of eight states that doesn’t license home health providers. Franklin County’s home health industry has grown by 195 percent during the same period, according to a report prepared for the newspaper by Wright State University.

- The U.S. Department of Health and Human Services’ Office of Inspector General found that 18 percent of home health agencies had questionable billing in 2012 in Ohio, one of eight states where such questionable billing was at least twice as prevalent as the national average.

- While home health care accounts for less than 5 percent of the state’s Medicaid spending, it accounts for more than half of improper Medicaid payments to providers in the state’s past three fiscal years.

Franklin County’s 264 home health care agencies certified by Medicare amount to one-third of all such businesses in Ohio. It is home to nearly half - 103 of 218 - of the agencies statewide that are pursuing such certification.

Hundreds of other agencies aren’t authorized to bill Medicare but can provide care and get paid through Medicaid programs and local senior levies and by families who hire on the private-pay market.

“We have just way too many agencies in Franklin County,” said Beth Foster, director of regulatory affairs for the Ohio Council for Home Care & Hospice, which represents home health care agencies throughout the state.

Nearly 60 percent of cases handled by the state’s Medicaid Fraud Control Unit each year involve home health care providers, the investigation found.

Law-enforcement officials describe a world in which for-profit companies illegally pay recruiters to funnel clients their way, with the clients’ need for care questionable at best, the paper said.

The growth of home health care coincided with a push by state leaders to keep more older and disabled people at home instead of in nursing facilities, a shift that saves the state money.


Information from: The Columbus Dispatch, https://www.dispatch.com

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