Fraud and abuse in home healthcare for the elderly and disabled

The Boston Globe reports that the Massachusetts Medicaid program has significantly increased spending on home healthcare in the last decade, while reports of fraud, abuse, and neglect have tripled. This raises new concerns about the lack of training, certification, and criminal background checks for personal care attendants as well as minimal oversight for the low-paid healthcare workers.

Federal investigators from the Government Accountability Office have also found rampant abuse in the Medicare home healthcare program for the elderly, including $200 million paid for care that was never provided. Between 2002 and 2006, spending for the program increased 44%, while the number of patients rose by only 17%.

The union representing personal care attendants, the director of the state's Medicaid program, and the Director of the Boston Center for Independent Living defend the program as meeting the demands of consumers who are elderly and disabled as well as being cost efficient.

Bill Henning, from the Boston CIL says,

"This is a program with inherent risks, and we would be happy to overhaul it in a lot of ways. But there's a lot of turnover in this field, and there's a real concern that we could choke off the supply of attendants."

Tom Dehner, the director of the state Medicaid program, is reluctant to increase regulation:

"We believe that consumer control of this program and service is intensely personal...We think consumers are in the best position to direct when and how to receive these services and train people and supervise them."

A woman with severe spastic cerebral palsy who has been bullied, threatened, and intimidated by personal care attendants (she has hired and fired scores of them), thinks otherwise:

"You can never be sure who you hire, and I check all their references...It would be nice, at the least, for the state to allow us to do a free criminal background check."