NAHC on Medicare Fraud Strike Task Force

A statement by Val J. Halamandaris, president of the National Association for Home Care & Hospice (NAHC): “On behalf of the members of the NAHC I want to congratulate the Medicare Fraud Strike Task Force and law enforcement agencies for taking forthright action to stem what appears to be a coordinated scheme to divert federal money intended for care of the aged and infirm. We believe that all Americans are entitled to the presumption of innocence, and we do not want to prejudge this case without having all the facts. However, the facts on the surface appear to be fairly compelling.

“NAHC has always had a zero-tolerance policy for those who would look to divert funds from Medicare and Medicaid for their own personal gain. We have taken a very focused and aggressive approach to fraud and abuse concerns in home health care. NAHC believes that patients and providers alike have the duty to help maintain the fiscal integrity of government programs. Additionally, we believe we should not discourage the thousands who are struggling to do a great job in caring for the ill, infirm and people with disabilities, and who will need to provide home-care services to the large percentage of the 78 million baby boomers.

“The health care reform law includes numerous provisions that NAHC initiated to help stop high risk parties from entering Medicare in the first place as well as to catch them as quickly as possible when they fail to properly safeguard Medicare. These include stricter provider participation screenings, the authority for a moratorium on new providers, and the highly successful limit on outlier billings that eliminated a systemic abuse by certain home health businesses. We believe it is imperative that home health agencies faithfully execute physician orders calling for the extension of in-home medical care while following the highest standards of care. As disappointing as this case is, it is heartening to see federal and state officials collaborating to stop allegedly inappropriate and perhaps illegal activities rather than imposing ineffective new regulatory requirements on all home health agencies.

“NAHC is continuing the effort to strengthen program integrity measures in Medicare and Medicaid with a series of proposals that include home health management credentialing and a requirement that all home health agencies have a corporate compliance plan. “The fraud committed by the very few, hurts all of home care and the patients we serve. The industry must be a leader in in health care compliance and program integrity. NAHC has made great progress in that regard and will continue to set the gold standard for all of health care.”

Halamandaris served as counsel to the U.S. Senate and House Committees on Aging for some 20 years. Before coming to NAHC as its CEO in 1982, he helped write the laws creating the Office of Inspector General in the Department of Health & Human Services, making Medicare and Medicaid fraud a felony, outlawing kickbacks, upgrading the mail fraud statute and creating state Medicaid fraud units.The National Association for Home Care & Hospice (NAHC) is a nonprofit organization that represents the nation’s 33,000 home care and hospice organizations. NAHC also advocates for the more than two million nurses, therapists, aides and other caregivers employed by such organizations to provide in-home services to some 12 million Americans each year who are infirm, chronically ill and disabled. Along with its advocacy, NAHC provides information to help its members provide the highest quality of care and is committed to excellence in every respect. To learn more visit www.nahc.org.

From the Homecare Magazine Article