AAHomecare Runs Roll Call Letter Urging Better Fraud Effort
WASHINGTON--The American Association for Homecare published an open letter to Congress Wednesday in Roll Call, a popular Capitol Hill newspaper, charging that the government has not done its job in curbing DME fraud.

While Congress has "finally enacted" provider accreditation and quality standards, the association said, the letter calls for a congressional review of the program's existing processes for approving providers.

According to the letter: "Medicare and its private contractors have failed to shoulder the proper responsibility to effectively exercise their already-existing authority to combat fraudulent activity. They must insist on standards and other up-front controls that will deny illegitimate operators any chance of taking advantage of Medicare ...

"Congress must review Medicare's existing processes for approving new durable medical equipment providers and auditing them after their supplier numbers are granted by CMS. Medicare's Program Integrity Unit and Program Safeguard Contractors already have tools at their disposal to inspect, monitor and audit such providers."

Referring to reports of rampant fraud in South Florida, the letter continued, "It is clear that such systems failed in Miami, where a number of fraudulent operations were recently shut down." (See HomeCare Monday, April 2.)

The letter also said providers need "clear, up-to-date and fair federal regulations that effectively target fraud and abuse but at the same time do not unduly burden those companies that make every effort to follow the rules."

At its recent Washington Legislative Conference, AAHomecare President Tyler Wilson suggested that new providers entering the system be granted only temporary supplier numbers and be placed on "100 percent prepayment review," with an onsite visit from the National Supplier Clearinghouse within a year.

"The sad fact is that in some quarters in Washington, tales of a tiny percentage of home medical equipment fraudsters wag the entire dog when it comes to home care policy," Wilson said, noting that reports of fraud detract lawmakers' attention from "the immediate, critical threats to home care" such as competitive bidding and additional cuts to oxygen.

The full text of the letter is available at www.aahomecare.org.