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Posted to Web: October 01, 2003

Permanent Link: http://www.urban.org/url.cfm?ID=1000836

In this article, the authors report findings from the first national study of so-called Medicare maximization billing practices for home care services, whereby states attempt to transfer home care costs from Medicaid to Medicare. The analysis indicated that seven states recovered as much as $265 million from Medicare the 1990s. The authors conclude that, while retrospective billing practices may aid states in reducing Medicaid outlays and potentially help dual Medicare beneficiaries gain coverage for their home care, these practices increased Medicare home care expenditures. The findings highlight the need for reforming our national long-term care financing policy. (Anderson, Wayne, Genevieve Kenney, and Donna Rabiner. October 2003. "Adoption of Retrospective Medicare Maximization Programs by State Medicaid Home Care Programs." Journal of Health Politics, Policy, and Law 28(5): 859-881.)

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