WASHINGTON--On Thursday, members of the House Ways and Means Health and Oversight subcommittee convened a Medicare program integrity hearing to ask law enforcement officials what tools they needed to ramp up the fight against fraud and abuse in the system.

While some, like R. Alexander Acosta, U.S. Attorney for the Southern District of Florida, said more funding would be helpful, HHS Inspector General Daniel Levinson said the OIG was adequately funded and recovered $13 for every dollar spent.

Questions from subcommittee members also centered on whether stiffer laws were needed for criminal prosecution of suspected fraud, an idea some agreed merited further consideration.

The American Association for Homecare also weighed in with a statement, stressing "zero tolerance for Medicare fraud and abuse of any kind."

The association cautioned against "any overgeneralizations about the home care sector" and championed more effective enforcement of the safeguards against fraud and abuse that Medicare currently has in place.

The association offered several suggestions for curbing 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 (42 CFR 424.57) 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," the association said.