NY Times Article Describes CMS-OIG Feud Over Fraud Numbers

A New York Times front page article on August 21 reports of a feud between the Office of Inspector General (OIG) and the Centers for Medicare and Medicaid Services (CMS) regarding the correct amount of fraud by criminals posing as legitimate home medical equipment providers. OIG says CMS is low-balling the fraud numbers after CMS told Congress the amount of fraud related to medical equipment is $700 million.

The top-ranking Republican on the Senate Finance Committee, Charles Grassley (R-Iowa), calls for “heads to roll” at CMS and in the House, Representative Pete Stark (D-Calif.) called CMS “incompetent.” Meanwhile, CMS has been complaining they don’t have enough anti-fraud resources from Congress.
The American Association for Homecare applauds efforts to get the numbers right and more important, to stop fraud in Medicare. However, the reporter for this article, Charles Duhigg, incorrectly describes competitive bidding as a fraud prevention mechanism that was stopped by industry lobbying. The action by Congress in July to delay and fix the deeply flawed bidding program will not reduce or delay efforts to combat fraud. The exact opposite is true. Congress strengthened the accreditation requirements in the new Medicare law and closed a loophole that would have allowed non-accredited providers to serve Medicare beneficiaries.

We will continue to support and help Congress and federal agencies to seek more effective ways of keeping criminals out of the Medicare program.

To read the NY Times article visit: http://www.nytimes.com/2008/08/21/business/21medicare.html?_r=1&hp&oref=slogin.