NPR Follow-Up Puts ‘Positive Light on our Plight,’ Provider Says
WASHINGTON–Blaming limited resources, a CMS official admitted
on a National Public Radio piece airing last week that the agency
has not been on the lookout for fraud–for years.
“In the past, perhaps we have not been as vigilant as we could
have been,” Kimberly Brandt, head of program integrity for
Medicare, told NPR reporter Greg Allen.
Brandt’s admission was, for industry stakeholders, one of the
highlights of Allen’s Nov. 6 report, which was a follow-up to his
controversial piece on the home care industry and Medicare fraud
that aired Oct. 11 (see
HomeCare Monday, Oct. 22). Stakeholders lambasted that
report as being one-sided and maligning all providers as “crooks.”
In an angry blitz of e-mails and phone calls to Allen, they called
on the reporter to tell their side of the story.
On Tuesday, he did–and stakeholders were mollified, at least to
some degree.
“The follow-up piece … corrected two major problems in the
first story,” said Michael Reinemer, vice president, communications
and policy for the American Association for Homecare. “In the
follow-up, the reporter spoke with a real HME provider in the Miami
area and he looked at the role of CMS in preventing fraud in the
first place.”
For the second story, Allen spoke with Raul Lopez, director of
operations for Bayshore Dura Medical in Miami Lakes, Fla., and
former president of the Florida Association of Medical Equipment
Services.
“He spent about two hours with me,” Lopez said, adding that he
took Allen on a tour of his company’s 14,000-square-foot facility
and tried to give the reporter a true sense of the HME industry and
the problems it faces. Lopez told Allen that the industry itself
has raised numerous red flags over the years in attempts to get CMS
to act on fraudulent activities, but to no avail.
“We have been screaming about this for far longer than CMS is
willing to admit,” Lopez said, noting that he was pleased Allen
talked with a CMS official and addressed the issue in his Nov. 6
piece.
“Finally, Kimberly Brandt admits that [CMS] didn’t do anything
about it. They didn’t actually look for fraud, and it’s been going
on for 10, 15, 20 years,” Lopez said.
The South Florida provider said Allen’s second piece showed that
“there are legitimate providers who are trying to get rid of fraud
… It put a more positive light on our plight.”
Reinemer called the CMS admission “a step forward” for the
industry. However, he noted, “we still object to the notion that
the home care business is ‘rife with fraud,’ which is an
exaggeration. There is more that could have been said about the
cost-effectiveness of home care, but that wasn’t the focus of this
particular story.”
Lopez, too, thought the piece was short and could have included
more questions about why CMS has allowed obvious fraudulent claims
to be processed. Still, while Allen’s follow-up had its
shortcomings, it has given providers and other industry
stakeholders a valuable tool, he said.
“It’s really good that [Allen] included the comments from CMS. I
think that is the perfect thing for people to go in with when they
see their congressman,” Lopez said. “It’s a huge advantage for
those of us who go and lobby our congressmen and senators because
it shows they haven’t been getting ‘the whole truth and nothing
but’ for years.”
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