Wednesday, November 11, 2009

Poynter Institute Encourages Second Look At DME Fraud Story—Legitimate Homecare Providers Are Hurt by Medicare Fraud

The Poynter Institute, a school and resource for journalists, recently posted a story idea for journalists which included the suggestion that all providers in the HME sector are, by definition, criminals. AAHomecare responded to their mistake, and the Poynter Institute’s Al Tompkins posted the following update:

I heard from a group called the American Association for Homecare, which represents business that sell home medical equipment. The spokesman for the group, Michael Reinemer, says journalists should look into how Medicare fraud is hurting legitimate medical equipment providers. He commented on the piece I wrote about the investigation ( and sent me an e-mail with his thoughts.

In his e-mail, Reinemer said these providers furnish "... not just the equipment but all the accompanying, required services that allow seniors to get the care they need and remain independent at home."

The legitimate businesses, Reinemer said, have actually asked Medicare to be more strict in its oversight ( and to try to do something to weed out what the federal government says is $60 billion in Medicare fraud. Reinemer wrote:

"There is a terrific story to be told, but it won't help the public understand this issue if you leave out the fact that the vast majority of home medical equipment providers are scrupulously honest, pray to actually get reimbursed for equipment and services they have in fact furnished, and have fought for decades for Medicare to adopt higher standards for those businesses to whom they give Medicare a supplier number (the credential to bill Medicare). Moreover, as of 2009, home medical equipment providers (DMEs) must be accredited by a federally recognized accrediting agency, they must meet surety bond requirements, and meet a host of other mandated standards. We were gratified to see that you told the story of one beneficiary who complained for years that a supplier company was charging Medicare for things she didn't need or receive. "

Why does Medicare support homecare? Because if a patient can get health care at home rather than in a hospital, it is a huge cost savings and often is more comfortable. Here are some basic stats about homecare that provide additional insight, as well as information about how home health care can help save money

I think Reinemer is right. His arguments address an interesting part of the health care reform story. As American ages, homecare suppliers will become increasingly important.

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