Senate Finance Committee accuses home health companies of 'gaming' Medicare

Three of the nation’s largest for-profit home health companies are “gaming” Medicare, concluded a report released Monday by the Senate Finance Committee. The report accuses Amedisys, LHC Group and Gentiva of intentionally increasing the number of their home health visits in order to plump their profits.

In May 2010, Max Baucus (D-Mont.), Senate Finance Committee chairman, and Chuck Grassley (R-Iowa), senior finance committee member, spearheaded an investigation into home health therapy practices at Amedisys, LHC, Gentiva and Almost Family after the Wall Street Journal published a story examining how these companies were taking advantage of the Medicare therapy payment system by providing medically unnecessary therapy visits.

The finance committee’s staff report, based on a review of internal documents provided by the companies, found that Amedisys, LHC and Gentiva actually had strategies in place to increase therapy visits for the purpose of boosting their own revenue. The report notes that while patient visit patterns at Almost Family resembled those of the other investigated home health companies, none of the documentation provided by Almost Family indicated the company’s executives had strategies in place to increase visits.

“The home health therapy practices identified at Amedisys, LHC Group, and Gentiva at best represent abuses of the Medicare home health program,” the report said. “At worst, they may be examples of for-profit companies defrauding the Medicare home health program at the expense of taxpayers.”

“The gaming of Medicare represents serious abuse of the home health program,” said Baucus in a statement accompanying the report. “Elderly patients in the Medicare system should not be used as pawns to increase a company’s profits. Especially in these tough economic times, taxpayers simply cannot afford for their dollars to be wasted on unnecessary care. We are going to continue to crack down on these companies to ensure taxpayer dollars are used efficiently and Medicare patients are protected.”

LHC, Gentiva, Almost Home and Amedisys did not respond to requests for comment for this story, but Amedisys and Gentiva did release statements responding the finance committee's report. “We are disappointed with the Committee's conclusions, and we stand by our company's integrity, ethics and patient care practices,” the Amedisys statement reads in part. “We are proud of our mission, which is to provide the highest quality care for our nation's chronically ill, elderly population, while managing a compliant, efficient and financially sound business.”

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