Home Health & Hospice Week

Your report can contribute to CMS's 'heat map.'

Home care providers often voice frustration when they try to report fraud and get no feedback. But your complaints may not be falling on deaf ears after all.

"Taking down a fraud scheme can often start with a tip from any number of sources such as a call from a Medicare beneficiary or caregiver, an employee or a concerned citizen to 1-800-MEDICARE," the Centers for Medicare & Medicaid Services' Peter Budetti said in testimony before the Senate Finance Committee April 24.

Your report won't just get chucked in the old circular file, Budetti promised. "CMS screens every complaint to the hotline for potential fraud," he said.

CMS "has implemented a geospatial toolset to create a national 'heat map' of tips that raise a question about possible fraud," Budetti explained. "The technology has the ability to track such calls to identify changing trends and new hot spots just as they are emerging."

So even if your complaint doesn't trigger individual action, it can focus scrutiny on the region, which hopefully will lead to investigation of shady providers in your area, he implied.

The downside: Additional scrutiny in your geographic area could lead to hassles for legitimate providers, including yourself, observers predict.