AAHomecare Runs Roll Call Letter Urging Better Fraud Effort

AAHomecare Runs Roll Call Letter Urging Better
Fraud Effort
WASHINGTON–The American Association for Homecare published an open
letter to Congress Wednesday in Roll Call, a popular
Capitol Hill newspaper, charging that the government has not done
its job in curbing DME fraud.

While Congress has “finally enacted” provider accreditation and
quality standards, the association said, the letter calls for a
congressional review of the program’s existing processes for
approving providers.

According to the letter: “Medicare and its private contractors
have failed to shoulder the proper responsibility to effectively
exercise their already-existing authority to combat fraudulent
activity. They must insist on standards and other up-front controls
that will deny illegitimate operators any chance of taking
advantage of Medicare …

“Congress must review Medicare’s existing processes for
approving new durable medical equipment providers and auditing them
after their supplier numbers are granted by CMS. Medicare’s Program
Integrity Unit and Program Safeguard Contractors already have tools
at their disposal to inspect, monitor and audit such
providers.”

Referring to reports of rampant fraud in South Florida, the
letter continued, “It is clear that such systems failed in Miami,
where a number of fraudulent operations were recently shut down.”
(See HomeCare Monday, April 2.)

The letter also said providers need “clear, up-to-date and fair
federal regulations that effectively target fraud and abuse but at
the same time do not unduly burden those companies that make every
effort to follow the rules.”

At its recent Washington Legislative Conference, AAHomecare
President Tyler Wilson suggested that new providers entering the
system be granted only temporary supplier numbers and be placed on
“100 percent prepayment review,” with an onsite visit from the
National Supplier Clearinghouse within a year.

“The sad fact is that in some quarters in Washington, tales of a
tiny percentage of home medical equipment fraudsters wag the entire
dog when it comes to home care policy,” Wilson said, noting that
reports of fraud detract lawmakers’ attention from “the immediate,
critical threats to home care” such as competitive bidding and
additional cuts to oxygen.

The full text of the letter is available at www.aahomecare.org.