Fraud & Abuse:
HHAs Have Lost Their Appeal As Fraud Targets
Published on Mon Jul 21, 2003
Top reasons the feds have let home health agencies slip out of the crosshairs include: 1) HHAs took the hint and tightened up their compliance efforts under the HHS Office of Inspector General's scrutiny. "The Feds made their point and most of home care listened," notes Indianapolis-based attorney John Gilliland. 2) The implementation of the prospective payment system has removed most of the juicy fraud targets. "With the PPS system, the two most frequent paths to Medicare abuse were cut off - overutilization and cost report manipulation," points out Bob Wardwell, with the Visiting Nurse Associations of America. 3) And HHAs aren't rolling in the dough under PPS either, Wardwell adds. Under the previous cost-based reimbursement system, a few bad apples were funneling millions to owners and executives.