CMS Holds Meetings On Fraud In Hospice, Home Health

WASHINGTON—The Centers for Medicare and Medicaid Services (CMS) held a series of listening sessions hosted by CMS Administrator Dr. Mehmet Oz on home health and hospice fraud in Los Angeles. The sessions were attended by staff of LeadingAge national, LeadingAge California and The National Alliance for Care at Home. 

“Our nonprofit and mission-driven members are committed to delivering high-quality, compliant care to beneficiaries,” said Katie Smith Sloan, president and CEO of LeadingAge. “We share CMS’ goal of combatting fraud in home health and hospice care settings, as our advocacy in recent years on these issues demonstrates, and we appreciate having the opportunity today to discuss providers’ experiences in Los Angeles, ways to work with the agency to address fraud and strengthen regulatory safeguards, and overall needs relevant to our longstanding advocacy efforts specific to fraud in hospice and home health.”

In December, LeadingAge wrote a letter in collaboration with the National Alliance for Care at Home penning recommendations to strengthen home health and hospice programs’ integrity. The organizations encouraged CMS to adopt stronger measures that can ensure a better defense against fraud and fraudulent claims. 

“Program integrity is a key priority for the Alliance, and the Alliance has worked closely with CMS, lawmakers and regulators, in partnership with its members and the broader care at home community, to ensure the ideals at the heart of these care models are upheld in the practice of care,” the Alliance said in a released statement. “Care at home providers put patients’ values, needs, and goals first, creating a plan of care specific to each patient and family. As part of an ongoing dialogue with CMS, the Alliance, in partnership with LeadingAge, recently submitted a letter to Dr. Mehmet Oz regarding Recommendations to Strengthen Home Health and Hospice Program Integrity.”  

“Fraud in any care setting is deeply concerning and also preventable,” Sloan said. “We believe it can be effectively addressed while critically reducing burden on legitimate providers furnishing essential services in the home. As we explain in our Dec. 22 letter to CMS, written in collaboration with the National Alliance for Care at Home, we encourage the agency to adopt measures that are analytically rigorous, operationally feasible, and take a targeted risk-based approach, consistent with its statutory authorities.”

“We thank CMS for initiating this productive meeting, and for the input from Administrator Oz, Deputy Administrator and Chief Operating Officer Kim Brandt, and Deputy Administrator and Director of Medicare Chris Klomp. We look forward to continuing collaboration on this important issue,” Sloan said. 

“The Alliance appreciates the opportunity to continue our dialogue with CMS about ensuring program integrity across these essential home-based services,” said Dr. Steve Landers, CEO of the Alliance. “We share the administration’s goal of eliminating fraud, waste, and abuse in home health and hospice care, and will continue to partner with the agency as it pursues solutions that reduce the burden on legitimate providers and protect patient access to care at home.”