Billing High for Workers with Low Pay

Some insurance companies are demanding high pay for the services of direct support workers.  Direct support workers help those with physical/mental challenges with daily living skills.  They make $10-$15 on average.

A few home health agencies in New York are participating in this trend.  The state is billing the agencies around $67 for their services.  Agencies that provide services for senior citizens in New York are only being charged around $21 for their services.

“They basically try and line their pockets by billing as much as possible — the more people and the more services, the more they line their pockets,” stated Courtney Burke, commissioner of New York’s State Office for People with Developmental Disabilities.  Ms. Burke also stated her goal was to change “the incentives in the system, to be focused on not quantity, but quality.”

High billing costs earn billions for agencies and executives.  This could be one reason why Medicaid spending has risen overwhelmingly for people with physical/mental challenges in New York recently.  One agency was billed $30,000+ for their work, and the executive director earns $400,000 yearly.

Billing scandal:  http://www.nytimes.com/2011/12/14/nyregion/caring-for-disabled-at-home-nonprofits-swim-in-new-york-state-money.html?pagewanted=1&_r=1