We Are the Good Guys

For at least 30 years, the HME industry has been at the forefront of stamping out Medicare fraud and abuse.

So it's not just insulting, it's infuriating when some policymakers paint the entire industry as being rife with fraud and abuse. (Surely no honest member of Congress wants to be branded with a bribery or corruption label just because of a few rotten apples in the halls of Congress.)

The few bad actors operating fly-by-night home care scams in Medicare are not a part of our community, which has been championing higher standards for decades. So, if or when the fraud issue comes up in discussions with policymakers, it's worth providing some history and perspective.

Our industry's continuing commitment to fighting fraud and abuse is a model of responsible action going back a long time. In 1987, our predecessor organization, NAMES, established a code of ethics to set a high standard of conduct for the industry. We created a code of conduct in 1990 to prescribe specific steps to ensure high standards. In 1992, we began working with the National Health Care Anti-Fraud Association.

We helped enact the Social Security Act Amendments of 1994, legislation to prevent fraud. In Senate testimony in 1995, we stated that “even one unscrupulous home medical equipment provider is one too many.” That testimony described 18 specific steps the industry had taken to prevent fraud and abuse.

The long list of actions we have taken to fight fraud continues up to the present day, and is ongoing. We must all remain vigilant about ferreting out and reporting fraud and abuse.

Also, we must remind policymakers that both the federal government and the industry play key roles in combating fraud, and those roles are most effective when there is a partnership rather than an adversarial relationship. Last month, the American Association for Homecare again stressed its zero tolerance for Medicare fraud and abuse in a statement to the House Ways and Means subcommittees on health and oversight. Our statement reminded Congress to avoid any overgeneralizations about the home care sector.

We also offered the subcommittees three suggestions for addressing fraud and abuse:

1. The guiding principle should be providing Medicare beneficiaries with medical equipment technology and therapies that are medically necessary and appropriate.