At a Senate hearing yesterday, the American Association for Homecare submitted a statement and issued a press release outlining the Association’s 13-point plan to stop fraud in Medicare. The statement reads, “Our legislative action plan is designed to protect these patients and their families—as well as the American taxpayers—by stopping fraud and abuse in the Medicare system before it can start. The plan targets fraud and abuse at the source through proposed policies that will ensure that providers who participate in Medicare are responsible, legitimate businesses and those disreputable actors are locked out of the system and prevented from abusing the public trust.”
The AAHomecare statement also said, “It is important to note that the American Association for Homecare welcomes a full and thorough review of reimbursement policies for durable medical equipment to ensure that Medicare payments reflect the true costs of providing home medical care to beneficiaries.” (See Newsroom at www.aahomecare.org to view the full statement.)
Both Senators and government witnesses discussed steps to reduce waste and fraud in the durable medical equipment sector, unfortunately including the use of the “competitive” bidding program as an anti-fraud tool and a panacea for Medicare reform.
The hearing was conducted by the Senate Committee on Homeland Security and Governmental Affairs Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security.
The Centers for Medicare and Medicaid Services (CMS) testified that “CMS is pursuing a ‘stop-gap program’ to focus on Medicare fraud in seven high-risk areas across the country where CMS is increasing our oversight of the highest paid DMEPOS suppliers and the highest billed DMEPOS equipment and supplies. The ‘stop-gap program’ increases pre-payment reviews of medical equipment suppliers and will also single out the highest-billed claims–continuous positive airway pressure (CPAP) devices, oxygen equipment, glucose monitors and test strips, and power wheelchairs…. The plan toughens the background checks on new suppliers and increases scrutiny on the highest ordering physicians and the highest utilizing beneficiaries.”
Both the hearing and the OIG report underscore the sorry state of Medicare fraud prevention in the United States, which has had a tragic, adverse impact on the vast majority of home medical equipment providers who fully comply with the law and that provide high quality services to seniors and people with disabilities who require medical equipment and care.