Partnership of Medicaid Home-Based Care Issues Statement on Program Integrity

WASHINGTON, D.C. (October 12, 2016)—David J. Totaro, chairman of the Partnership for Medicaid Home-Based Care (PMHC), issued the following statement today in response to a recent call by the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) concerning improved program integrity in personal care services:

“The Partnership for Medicaid Home-Based Care was established in 2015 to advance the delivery of high-quality, cost-effective Medicaid home-based personal and skilled care through proactive and constructive engagement with government leaders and across the Medicaid home-based care community.

“In keeping with our mission, we are committed to elimination of fraud and abuse in the Medicaid personal care services program. Our community has long shared the OIG’s determination to identify and eliminate inappropriate activity in the personal care services sector. As such, we accept the challenge inherent in the call for implementation of new strategies to eliminate fraud and abuse because of their importance to older and disabled Americans and the contribution they can make to ensuring the integrity, efficiency and effectiveness of the Medicaid program as a whole. At the same time, we acknowledge that effective implementation of policies to improve program integrity has many challenges when we consider the multitude of unique Medicaid Personal Care Programs across the fifty states. As a Partnership, we are committed to working with the HCBS community to develop and implement improvements to bring greater uniformity and accountability in Medicaid Personal Care Services.

“We are proud of the high standards set and maintained by Partnership members, which include sophisticated compliance programs, intensive staff selection and training protocols, and substantial investment in processes to ensure the care we are charged to deliver is of the highest quality possible. At the same time, we recognize that not every provider in this program meets such standards, and we agree that gaps must be addressed and closed at the earliest possible opportunity. Towards that end, we believe that those home-based care providers that directly employ and supervise their caregivers are best able to consistently achieve the high standards and care quality that older and disabled Americans deserve.

“It is well known that older and disabled citizens overwhelmingly wish to receive safe and dignified care in their homes, where they are able to remain close to family and a part of their community. It is therefore essential that every caregiver who has the privilege of serving older and disabled Americans be held to the same level of screening, training, supervision and accountability that is recommended by the OIG and upheld every day by Partnership members.

“We look forward to working with the Centers for Medicare and Medicaid Services, the Secretary, State Medicaid Agencies and Congress to strengthen and preserve the increasingly invaluable role that the Medicaid personal care services benefit fulfills in communities all across America.”

PMHC is comprised of organizations representing homecare agencies, associations, technology vendors and payers who have come together to improve the quality and integrity of Medicaid funded home- and community-based services (HCBS). Recognizing the integral role of home- and community-based care in the Medicaid program, the PMHC is dedicated to advancing and supporting public policies that bring accountability to and secure the Medicaid program for care recipients and taxpayers alike.

Members of PMHC include AccentCare, Inc., Addus HomeCare, Inc., All Metro Health Care, BAYADA Home Health Care, CareCentrix, Caring Associates, Inc., CellTrak Technologies, Inc., Centene, HHAeXchange, Home Care Association of America, Home Care by Blackstone, Interim HealthCare Inc., LHC Group, Inc., Molina Healthcare, Inc., ResCare Home Care, Sandata, Sutter Care at Home, The Council of State Home Care Associations, VNA Health Group and WellCare Health Plans.