Colorado Officials Promise Increased Enforcement of Home Care Standards After Audit Finds ‘Deficiencies’

After an audit of Colorado home health care providers found that some of the services "put patients at risk," the state Department of Health Care Policy and Financing said it would "strengthen standards" to ensure providers are meeting quality requirements under Medicaid, the AP/Colorado Springs Gazette reports (AP/Colorado Springs Gazette, 7/24). Testifying before state lawmakers, auditors said, "We found that there were at least five providers who met the state's criteria for terminating their Medicaid agreements." Noting that the five providers had at least two standards violations, and some of those had up to 12 deficiencies in the four most recent state reviews, the audit stated, "These situations placed the clients in immediate jeopardy." To date, however, the state has "never used its authority to shut down an operator" (Sanko, Denver Rocky Mountain News, 7/24). And while the Health Care Policy and Financing Department monitors the state's home health providers, its officials do not have the authority to "impose sanctions" (AP/Colorado Springs Gazette, 7/24). Moreover, current enforcement policies offer an "all or nothing" approach: providers are either terminated from the Medicaid program or permitted to operate despite "shoddy" work (Denver Rocky Mountain News, 7/24). Department Director Karen Reinertson said that the lack of sanctions forces the agency to choose between "pull[ing] the plug," leaving patients without care, or "trying to get the provider to improve standards" without levying consequences for violations (AP/Colorado Springs Gazette, 7/24). Therefore, the News reports that auditors are recommending an "intermediate range of sanctions" for violators of Medicaid standards, "including financial penalties and denial of payment" (Denver Rocky Mountain News, 7/24). According to the Gazette, state lawmakers are considering "adding [such] penalties" for providers who "continue to have problems" (AP/Colorado Springs Gazette, 7/24).