AAHomecare Takes a Stand Against Medicare Fraud

In recent months the media and Congress have been focusing on Medicare fraud and initiatives to help curtail the rising cost associated with fraud. The American Association for Homecare (AAHomecare) supports Congress efforts. Fraud hurts all legitimate home medical equipment providers.

AAHomecare is currently working on a legislative strategy that will help keep criminals out of Medicare. The Association staff is reviewing specific measures that could be used by the Centers for Medicare and Medicaid Services (CMS) to stop fraud at the front-end of the payment process rather than relying on the current pay-and-chase system. The measures focus on increased scrutiny of new HME providers, real-time claims analysis, and accreditation, among other topics.

Over the past year, AAHomecare has worked closely with congressional offices on two separate anti-fraud efforts, including a rational approach to implementation of surety bond requirements for home medical equipment. In addition, AAHomecare staff provided input to Senators drafting the STOP Act, (Seniors and Taxpayers Obligation Protection Act of 2008, S. 3164) which requires the Secretary of Health and human services to change the Medicare beneficiary identifier used to identify Medicare beneficiaries under the Medicare program.

The Association has gone on record opposing the exemption from accreditation requirements for “eligible professionals” as outlined in section 154 (b)(F) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). According to CMS, this includes physicians, physical or occupational therapists, qualified speech-language pathologists and practitioners are exempt as “eligible professionals.” This list also includes physician assistants, certified registered nurse anesthetists, and clinical social workers, among others. Home medical equipment providers are not exempt. AAHomecare has also opposed an earlier announcement by CMS to postpone the accreditation deadline for providers taking part in Round Two of the DMEPOS Competitive Bidding Program.

Tyler J. Wilson, president and CEO of AAHomecare has commented that “accreditation helps to ensure that patients receive high-quality homecare, and it is also an important tool in preventing fraud in the Medicare program.”