Navigation Links
MedPAC Data Underscores Need for Targeted Medicare Reforms to Strengthen Program Integrity, Protect Patient Care

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 Medicare data indicates that a single payment reform relating to outlier claims that was proposed by the home healthcare community in 2009 achieved over $850 million in savings in 2010 alone – equivalent to nearly $11 billion in savings over the next 10 years.

While the Partnership supports efforts to advance targeted reforms, the community expressed concern that recommendations calling for beneficiary copayments for skilled home healthcare services and rebasing of Medicare home healthcare rates could potentially limit patient access to the clinically advanced, low-cost care that an overwhelming majority of American seniors prefer. Instead of using blunt instruments, such as copayments for low-income seniors or across-the-board reimbursement changes, the Partnership asks lawmakers to instead focus on strengthening Medicare and Medicaid through program integrity and payment reforms. 

The home healthcare community is also concerned that the recommendations related to adding copayments and rebasing do not reflect the true cost of providing care and may not reflect recent cuts to home healthcare payments because of the lag in available cost report data upon which the recommendations are based. The Partnership has engaged Avalere Health to analyze provider margins using more recent data.  This research is being undertaken in an effort to help inform the decision making process and to protect seniors and their providers from further cuts that could severely impact America's home healthcare delivery system.

Skilled home healthcare is the most cost-effective clinical care setting available for seniors today. Nearly 90 percent of American seniors prefer to age and receive treatment in their own home. Nationwide, more than 3.3 million Medicare beneficiaries receive skilled home healthcare to treat illnesses related to acute, chronic or rehabilitative needs.

The Partnership for Quality Home Healthcare was established in 2010 to assist government officials in ensuring access to quality home health services for all Americans. Representing more than 1,500 community- and hospital-based home health agencies nationwide, the Partnership is dedicated to developing innovative reforms to improve the program integrity, quality, and efficiency of home healthcare for our nation's seniors.

SOURCE Partnership for Quality Home Healthcare
Copyright©2010 PR Newswire.
All rights reserved

Related medicine technology :

1. Medpace Opens Clinical Pharmacology Unit in Cincinnati, Ohio
2. ACLA Voices Strong Concern Over MedPAC Proposal to Cut Medicare Reimbursement for Laboratory Services
3. Major deCODE-led Study Underscores Role of the Brain in Obesity
4. Research Published in Science Translational Medicine Underscores Value of Depression Gene Therapy License Held by Neurologix
5. Delay of Medicare Bidding Program for Home Medical Equipment Underscores Severe Problems with Program; Support Surges for Bipartisan Bill to Repeal the Bid Program
6. New Yorks Anti-Mandatory Mail Order Law Underscores Growing Skepticism of PBMs
7. St. Jude Discovers Factors That Accelerate Resistance to Gleevec(TM) Targeted Therapy in Lymphoblastic Leukemia
8. Targeted Genetics Reports on Recombinant DNA Advisory Committee (RAC) Review of its Phase 1/2 Trial of tgAAC94 for Rheumatoid Arthritis
9. Strategic Diagnostics Launches Initial Oncology-Targeted Antibody Reagent Catalog
10. Microarray Sequence Capture Speeds Large-Scale Resequencing of Targeted Genomic Regions
11. Targeted Nanoparticles Offer Promise in the Battle Against Cancer
Post Your Comments:
(Date:11/25/2015)... Nov. 25, 2015 Allergan plc (NYSE: ... and Rugen Therapeutics, a start-up  biotechnology company focused ... CNS disorders and funded by the F-Prime Biomedical ... entered into an exclusive collaboration to support the ... Spectrum Disorders (ASD) and Obsessive Compulsive disorders (OCD). ...
(Date:11/25/2015)... TEL AVIV, Israel , November 25, 2015 /PRNewswire/ ... firms (the "New Investors"), pursuant to which BioLight and ... in BioLight,s IOPtima Ltd. subsidiary ("IOPtima") via a private ... global commercialization of its innovative IOPtimate™ system used in ... a regulatory approval pathway process for the IOPtimate™ system ...
(Date:11/25/2015)... Research and Markets ( ) has announced the ... to 2020" report to their offering. ... the total market share in 2014. The market for ... to growth at the highest CAGR between 2015 and ... fast growing water, industrial gas treatment, pharmaceutical, and food ...
Breaking Medicine Technology:
(Date:11/25/2015)... (PRWEB) , ... November 25, 2015 , ... ... hands of philanthropic seniors, is resulting in a way for homeless people to ... in Schaumburg have launched a new initiative whereby they are repurposing plastic bags ...
(Date:11/25/2015)... ... November 25, 2015 , ... Students and parents have ... to winners of the Create Real Impact awards. California Casualty is proud ... stem the tide of distracted and reckless driving, the number one killer of young ...
(Date:11/24/2015)... ... ... Dr. Todd S. Afferica, a noted general dentist in Norcross, GA ... Afferica now uses the BIOLASE WaterLase iPlus 2.0™ in many of his dental procedures. ... traditional cutting tools, such as the scalpel and high-speed drill, which can both cause ...
(Date:11/24/2015)... ... November 24, 2015 , ... ThirdLove, the fast-growing bra company ... early, offering 40% off select bras and underwear styles, now through Saturday, November ... fit technology and the latest fashion, quickly becoming the next generation of luxury ...
(Date:11/24/2015)... ... November 24, 2015 , ... The hospitals and ... several aspects of orthopedic care. They have received recognition for excellence from various ... care. , Becker's Hospital Review selected hospitals for inclusion based on national ...
Breaking Medicine News(10 mins):