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American Association for Homecare Applauds Efforts to Eliminate Fraud in Medicare
Date:4/4/2012

d the need for CMS to ensure that its contractors are conducting effective site inspections for all new applicants for a Medicare supplier number. 

Status: Under its final rule implementing provider screening requirements in Section 6401 of the Patient Protection and Affordable Care Act (ACA), CMS requires that the National Supplier Clearinghouse (NSC) conduct a site visit for all newly enrolling HME providers.

2.      Require Site Inspections for All HME Provider Renewals. All renewal applications should require an in-person visit by the National Supplier Clearinghouse.

Status: Under its final rule for Section 6401 of ACA, CMS requires that NSC conduct a site visit for all HME providers upon revalidation of enrollment, which occurs every three years.

3.      Improve Validation of New Homecare Providers. Additional validation of new providers should be included in a comprehensive and effective application process for obtaining a Medicare supplier number. 

Status: Under its final rule for Section 6401 of ACA, CMS set up three risk categories for providers. Newly enrolling HME providers are in the "high risk" category, which requires that they undergo additional screening, including fingerprinting and background checks.

4.      Require Two Additional Random, Unannounced Site Visits for All New Providers. Two unannounced site visits should be conducted by the NSC during the first year of operation for new HME providers.

Status: Currently, the NSC must conduct at least one site visit. Agencies that accredit HME providers serving Medicare beneficiaries also must conduct a site visit as a part of accreditation. 

5.      Require a Six-Month Trial Period for New Providers.
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SOURCE American Association for Homecare
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