Summary: Pursuant to a congressional request, GAO reviewed the Health Care Financing Administration's (HCFA) process for surveying home health care agencies and certifying them for Medicare participation.
GAO found that: (1) HCFA contracted with states to periodically survey home health agencies, and certified those agencies that state surveyors determined to be in compliance with HCFA standards; (2) HCFA planned to issue guidance to help state surveyors implement recent legislative requirements that surveyors include measures of how agency services affected patient health status; (3) recent legislation also provided HCFA with a range of sanctions to impose on agencies that did not comply with standards; (4) HCFA guidance did not ensure that surveyors used sound methods to sample patient records for review or consistently interpret Medicare standards; (5) HCFA did not provide surveyors with the data that its claims processing contractors and peer review organizations developed during their reviews of home health agency performance; (6) HCFA regional offices did not fully analyze existing survey data to assess how well the states conducted surveys; and (7) HCFA home health agency standards did not address the qualifications and training of persons who provide high-technology treatments to Medicare beneficiaries.
