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American Association for Homecare Supports Crackdown on Medicare Scammers in Houston, Boston, New York, Louisiana
Date:7/30/2009

s analysis.

On May 6, 2009, Sen. Martinez introduced Seniors and Taxpayers Obligation Protection (STOP) Act, S. 975, which incorporates some of the anti-fraud measures proposed by AAHC in the 13-Point plan, such as:

  • Pre-enrollment site visits and unannounced site visits for new home medical equipment providers;
  • Site visits for current providers that are re-enrolling, as well as an unannounced site visit after re-enrollment;
  • Real-time data analysis (like that used to identify credit card charging patterns) to identify and investigate unusual billing and ordering practices that could indicate fraud or abuse; and
  • Checks to ensure that the provider is qualified and enrolled to bill the type of item or service that is on the claim for reimbursement.

The American Association for Homecare believes more must be done to stop fraud and abuse in the Medicare system and has been working with the Congress and Centers for Medicare & Medicaid Services (CMS) to move some of these proposals forward. For more information about the Anti-Fraud Legislative Action Plan, please visit: www.aahomecare.org/stopfraud. Please find the full plan below:

1) Mandate Site Inspections for All New Home Medical Equipment Providers

A July 2008 GAO report underscored the need for CMS to ensure that its contractors are conducting effective site inspections for all new applicants for a Medicare supplier number.

2) Require Site Inspections for All HME Provider Renewals

All renewal applications should require an in-person visit by the National Supplier Clearinghouse (NSC), the contractor that CMS uses to ensure integrity in the Medicare program.

3) Improve Validation of New Homecare Providers

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SOURCE American Association for Homecare
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