President Barack Obama’s detailed budget is scheduled for release on Thursday, May 7, and Medicare and Medicaid fraud and errors are a focus. According to the Wall Street Journal article “Budget Target Fraud and Errors in Social Programs,” by Jonathan Weisman, the White House estimates every dollar spent by the department of Health and Human Services to combat health-care fraud yields about $1.60 in savings. The budget will include a request for a total of $1.7 billion over five years for Obama’s health-care fraud initiative.
The American Association for Homecare has proposed 13 specific recommendations to stop fraud and abuse in the homecare sector. The steps would eliminate most of the Medicare fraud attributed to the home medical equipment sector by attacking the problem at the front of the process rather than relying on the “pay-and-chase” approach to stopping fraud.
For the full article which includes other agencies and programs expected to be mentioned in the budget, visit: http://online.wsj.com/article/SB124147959792585159.html
On May 6, the American Association for Homecare will submit a statement outlining the Association’s 13-point anti-fraud plan to the Senate Special Committee on Aging which will hold a hearing on Medicare waste, fraud, and abuse.
Tuesday, May 5, 2009
Monday, May 4, 2009
Three-quarters of Home Medical Equipment Providers Have Prepared for Flu Pandemic
In a survey of approximately 1,500 home medical or durable medical equipment providers conducted by the American Association for Homecare, more than half (53 percent) have formal plans to respond to a pandemic flu and another 23 percent have stockpiled N95 masks or other supplies related to a flu pandemic.
Eighteen percent said they are working on a formal plan and expect to have one in place within the week. Two-thirds say they are coordinating or communicating with other organizations in their communities to prepare for a pandemic.
“Home-based care is a centerpiece of the national pandemic flu response and in a pandemic situation, home medical equipment personnel will be on the front lines,” says Tyler J. Wilson, president of the Association.
The survey, which was conducted on April 30 and May 1, included responses from 147 homecare providers, collectively serving more than 2.5 million patients through more than 1,000 branch locations across 50 states.
Some homecare providers have had pandemic flu plans and training dating back several years. Pat Northheimer, clinical director at Cole Care in Coudersport, Pa., commented, “We had a pandemic flu drill three years ago that involved hospitals and local EMS. Projections were made with a scenario that worsened each day. It was very helpful in showing us just how bad things could get if the projections were accurate. The drill went into great detail.”
Apria Healthcare, a national home medical equipment and service provider headquartered in Lake Forest, Calif., tests emergency preparedness plans in its 500 locations at least annually and consults with local or state disaster preparedness authorities.
Bob McLellan, general manager of Pacific Coast Medical Supply, which operates one branch, in Astoria, Oregon, said, “We have notified local hospital, law enforcement, fire departments, and our local am radio station of our status and availability of services during emergencies.”
For further results and information about the survey or home medical equipment providers preparations for emergencies, please visit the Newsroom at www.aahomecare.org.
Eighteen percent said they are working on a formal plan and expect to have one in place within the week. Two-thirds say they are coordinating or communicating with other organizations in their communities to prepare for a pandemic.
“Home-based care is a centerpiece of the national pandemic flu response and in a pandemic situation, home medical equipment personnel will be on the front lines,” says Tyler J. Wilson, president of the Association.
The survey, which was conducted on April 30 and May 1, included responses from 147 homecare providers, collectively serving more than 2.5 million patients through more than 1,000 branch locations across 50 states.
Some homecare providers have had pandemic flu plans and training dating back several years. Pat Northheimer, clinical director at Cole Care in Coudersport, Pa., commented, “We had a pandemic flu drill three years ago that involved hospitals and local EMS. Projections were made with a scenario that worsened each day. It was very helpful in showing us just how bad things could get if the projections were accurate. The drill went into great detail.”
Apria Healthcare, a national home medical equipment and service provider headquartered in Lake Forest, Calif., tests emergency preparedness plans in its 500 locations at least annually and consults with local or state disaster preparedness authorities.
Bob McLellan, general manager of Pacific Coast Medical Supply, which operates one branch, in Astoria, Oregon, said, “We have notified local hospital, law enforcement, fire departments, and our local am radio station of our status and availability of services during emergencies.”
For further results and information about the survey or home medical equipment providers preparations for emergencies, please visit the Newsroom at www.aahomecare.org.
American Medical News Reports White House Gives Green Light on Medicare DME bidding program
Despite the home medical equipment sectors deep concerns over the flawed competitive bidding program, the American Medical News reports that the Obama Administration has giving the “green light” for CMS to conduct the program, which will start in 2010.
The White House delayed the effective date of the interim final rule for the program in February this year, but CMS announced the April 18 effective date would not be delayed further. This decision allows the agency to begin re-bidding for Round One of the program in 9 metropolitan statistical areas.
"We are very disappointed that CMS has moved forward with this program without allowing more opportunity to examine it. As designed, the program will eliminate approximately 90% of suppliers in any marketplace. We believe that is unacceptable, especially when all efforts by the [Obama] administration and Congress are aimed at job promotion and creation," Walter Gorski, vice president of government affairs for AAHomecare, told American Medical News.
If Congress had not stopped the program in July of 2008, it would have limited Medicare coverage of selected equipment in 10 metropolitan areas to suppliers that submitted winning bids.
Despite the final rule, CMS said it will have no immediate effect on how Medicare patients obtain durable medical equipment, prosthetics, orthotics and supplies. Beneficiaries may still use current suppliers.
Gorski said suppliers will continue to work with Congress on legislation to repeal the program, and they are hopeful that its language will be included in any health system reform bill that might be introduced this year. "We remain cautiously optimistic that we can show this program will not yield the results anticipated."
To view the full story, visit: http://www.ama-assn.org/amednews/2009/05/04/gvsd0504.htm
The White House delayed the effective date of the interim final rule for the program in February this year, but CMS announced the April 18 effective date would not be delayed further. This decision allows the agency to begin re-bidding for Round One of the program in 9 metropolitan statistical areas.
"We are very disappointed that CMS has moved forward with this program without allowing more opportunity to examine it. As designed, the program will eliminate approximately 90% of suppliers in any marketplace. We believe that is unacceptable, especially when all efforts by the [Obama] administration and Congress are aimed at job promotion and creation," Walter Gorski, vice president of government affairs for AAHomecare, told American Medical News.
If Congress had not stopped the program in July of 2008, it would have limited Medicare coverage of selected equipment in 10 metropolitan areas to suppliers that submitted winning bids.
Despite the final rule, CMS said it will have no immediate effect on how Medicare patients obtain durable medical equipment, prosthetics, orthotics and supplies. Beneficiaries may still use current suppliers.
Gorski said suppliers will continue to work with Congress on legislation to repeal the program, and they are hopeful that its language will be included in any health system reform bill that might be introduced this year. "We remain cautiously optimistic that we can show this program will not yield the results anticipated."
To view the full story, visit: http://www.ama-assn.org/amednews/2009/05/04/gvsd0504.htm
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