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MedPAC Data Underscores Need for Targeted Medicare Reforms to Strengthen Program Integrity, Protect Patient Care
Date:3/16/2012

WASHINGTON, March 16, 2012 /PRNewswire-USNewswire/ -- The Partnership for Quality Home Healthcare today praised the Medicare Payment Advisory Commission's (MedPAC) recommendation to target waste, fraud and abuse in the Medicare program.  The home healthcare community supports efforts to target abusive billing behaviors, including recommendations to "conduct medical review activities in counties that have aberrant home health utilization… [and] implement the new authorities to suspend payment and the enrollment of new providers if they indicate significant fraud." 

Analysis of MedPAC data show that abusive billing practices are occurring in isolated pockets of the country.  Indeed, of the nation's 3,143 counties and county-equivalents, MedPAC has identified the 25 counties in which the highest levels of Medicare utilization and suspected abuse are occurring.  As a result, the home healthcare community believes policy makers should undertake action to address targeted problems with targeted solutions.

"We are pleased with the Commission's recommendation and their recognition that fraud and abuse is a targeted problem requiring targeted reforms," said Billy Tauzin, former House Energy and Commerce Committee chairman and senior counsel to the Partnership for Quality Home Healthcare. "The home healthcare community has developed a set of detailed proposals to strengthen program integrity while protecting seniors, cost-efficient providers, and taxpayers alike.  We look forward to working with MedPAC, Congress and the Administration to see these recommendations through, so that lasting change benefiting seniors and taxpayers can be achieved."

Meaningful reforms developed by the home healthcare community offer a targeted solution, including firm limits on episode and low-utilization payments, in order to prevent fraudulent activity before it takes place. In addition to these reforms, analysis of recently-released Medic
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SOURCE Partnership for Quality Home Healthcare
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