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Home Medical Equipment Providers Are Appalled by 'Dead-Doctor' Scam, Strongly Support Anti-Fraud Efforts to Protect Medicare System
Date:7/9/2008

Statement by Tyler J. Wilson, President and CEO of the American Association for Homecare

ARLINGTON, Va., July 9 /PRNewswire-USNewswire/ -- Durable medical equipment manufacturers and providers are just as appalled as lawmakers and Medicare officials at the revelations that scam artists used identification numbers from deceased doctors to bilk millions of dollars from the Medicare system. The medical equipment providers and manufacturers represented by the American Association for Homecare stand united against fraud and abuse of the nation's Medicare system.

We are committed to rooting out fraud and abuse and are eager to continue working with Congress and the administration to improve program integrity for Medicare. We must also be clear, however, that it was lax oversight by the Centers for Medicare and Medicaid Services (CMS) that allowed the dead-doctor scams to operate. We fully support comprehensive efforts to keep supplier billing numbers out of the hands of these scam artists. Moreover, it must also be noted that these criminals are not members of our Association and are not part of the legitimate homecare industry that is committed to providing Medicare beneficiaries with quality service and products.

The vast majority of home medical equipment providers and manufacturers are operated by hard-working Americans, in many cases they are family operations involving multiple generations who are dedicated to providing the best possible therapies and medical equipment to treat and improve medical conditions for patients. The patients our members serve suffer from a variety of conditions ranging from multiple sclerosis and congestive heart disease to COPD. Law-abiding providers and manufacturers that we represent understand the importance of forming transparent, long-term relationships with the Medicare program and they make every effort to comply with Medicare's rules and regulations.

The American Association for Homecare strongly advocates accreditation requirements for durable medical equipment providers, which is long overdue. We also support prompt, reliable, and effective homecare products and services appropriate to each individual's needs, health and safety as well as compliance with applicable federal, state, and local laws and regulations.

We offer several suggestions for addressing fraud and abuse.

First, the guiding principle should be to provide Medicare beneficiaries with medical equipment technology and therapies that are medically necessary and appropriate to give the patient a fuller, more satisfying and healthier life.

Second, Medicare coverage, coding, reimbursement and documentation policies as well as standards for quality, should be clear and unambiguous. In recent years, for instance, AAHomecare has worked with CMS and its contractors to revise coding for power wheelchair products to improve Medicare coding and coverage practices.

The Association also has embraced the federal quality standards and accreditation requirements for home medical equipment required by the Medicare Modernization Act of 2003 (MMA) and has worked closely with CMS to develop sound quality standards. In fact, last year we recommended that CMS adopt standards that were far more stringent than what the agency adopted in its final standards issued in November 2006. Many of the requirements from the MMA are only now nearing implementation.

Third, the Medicare program has numerous anti-fraud and abuse safeguards in place that must be more effectively enforced. Currently, the Medicare program requires that suppliers adhere to 21 specific supplier standards in order to obtain and maintain billing privileges.

We believe that proper enforcement of the current 21 standards along with new quality standards and accreditation will go a long way toward cracking down on criminal activity. For example, Medicare and its contractors currently have the ability to conduct on-site inspections to ascertain the provider's compliance with the supplier standards. The National Supplier Clearinghouse (NSC) is also required to conduct on-site inspections when it issues a new supplier number and every three years upon renewal. Shell companies that are purposefully out to defraud the Medicare program should not be able to pass these unannounced site inspections.

The American Association for Homecare (AAHomecare) represents providers of durable medical equipment and related services and supplies as well as equipment manufacturers. AAHomecare members serve the medical needs of millions of Americans who require home oxygen equipment, wheelchairs and other mobility products, hospital beds, medical supplies, inhalation drug therapy, home infusion, and other medical equipment, therapies, services, and supplies delivered in the patient's home. AAHomecare's provider members operate more than 3,000 homecare locations in all 50 states. See http://www.aahomecare.org.


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SOURCE American Association for Homecare
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