Home Health & Hospice Week

Medicare providers asking for more regulatory scrutiny is an unusual step, but the home medical equipment industry has taken it in response to flagrant fraud that has given suppliers a bad name in some circles.

The American Association for Homecare has proposed an "aggressive 13-point plan to stop Medicare fraud and recoup billions," the trade group says in a release.

"The home care sector has zero tolerance for illegal activity, and we are frustrated that the problem seems to be growing rather than shrinking," says Tyler Wilson, AAHomecare president and CEO.

Increased site visits to suppliers is a major component of the plan. AAHomecare wants site inspections for all new HME suppliers, two additional random unannounced site visits for new suppliers, and in-person visits from the National Supplier Clearinghouse for all renewals.

NSC would conduct the random visits within the first year of operation, AAHomecare suggests.

New providers would be subject to many of the measures AAHomecare calls for. Under the proposal, they would face a tougher, more comprehensive application process; undergo a six-month trial period with a temporary Medicare number; and undergo post-payment sample claims reviews.

Other steps include increasing fines and penalties for fraud, conducting real-time claims analysis for all suppliers, and establishing more rigorous quality standards.

Some of the steps would help suppliers directly. For instance, AAHomecare proposes establishing due process procedures for suppliers when their supplier number applications are denied or numbers are revoked.