The Partnership for Quality Home Healthcare (PQHH) commended members of the Senate Finance Committee for urging regulators to increase efforts to combat Medicare waste, fraud and abuse.
Senators Orrin Hatch (R-UT), Chuck Grassley (R-IA) and Tom Coburn (R-OK) are urging the Centers for Medicare and Medicaid Services (CMS) to implement a moratorium on the installment of new providers in areas identified as “high-risk” to the Medicare program.
“We applaud the Senators’ leadership on this issue and strongly agree that increased program integrity measures are needed to stop the wasteful use of taxpayer dollars,” said Eric Berger, CEO of PQHH. “Our proposal provides a pro-patient solution that will achieve long term cost savings and Medicare program sustainability while protecting beneficiaries, compliant providers and taxpayers.”
As a coalition of home health providers dedicated to improving the quality and efficiency of home healthcare for seniors nationwide, PQHH has long supported program integrity reforms to curb fraud and abuse in the Medicare system.
PQHH has developed a proposal—the Skilled Home Health Integrity Program Savings (SHHIPS) Act—to combat the payment of falsified claims by tightening participation standards, strengthening claims review processes and creating payment safeguards.
Under the Partnership’s plan, the Secretary of the Department of Health and Human Services (HHS) is required to suspense the issuance of new home health provider numbers in counties with an over-saturation of providers, a factor associated with abnormal billing behavior.
“HHS and CMS have a duty to ensure that taxpayer dollar are being carefully stewarded and that all available tools are being utilized to combat health care fraud nationwide,” said HHS Secretary Kathleen Sebelius.
Last month, a MedPAC report confirmed that fraudulent and abusive billing practices in the home health sector are confined to isolated geographic areas of the country.
In this report, MedPAC identified 25 counties where the highest levels of deceptive Medicare billing and suspected abuse are occurring.
Written by Jason Oliva