AT HOME, the newsletter of the Mass Home Care Association, of which Elder Services is the Berkshire County member. It explains the squeeze in Medicare services being felt by many who are losing their home health care. The GAO report helps to explain many of the new restrictions placed on the program by a Congress that should rightfully share some of the responsibility for changes in the system that fueled the rapid growth in home health expenditures. The GAO report makes it clear, however, that Congress itself may be to blame for the skyrocketing expenditures on Medicare home health - not the home health agencies. According to the GAO, Medicare home health began in 1966 as a benefit for people recovering from illness or injury after a hospitalization.
More patients now receive home health services for longer periods of time.
Such changes, however, were not implemented by home health agencies, but by Congress. In 1980, Congress passed the Omnibus Budget Reconciliation Act, which broadened the original home health benefit. One-third of the people using home health benefits did not have a prior hospitalization. The GAO reported to Congress examples of wide-spread abuse of the liberalized rules for Medicare home health. Other agencies directed staff to alter or falsify records, logging visits that were never made.