Home Health & Hospice Week

Home health agencies and home medical equipment suppliers aren't the only ones singled out for a tough new fraud and abuse crackdown--infusion therapy providers also have entered the mix.

The infusion requirements will look all too familiar to HHAs and suppliers: "The Centers for Medicare & Medicaid Services will now require infusion providers who operate in several South Florida counties to immediately resubmit applications to be a qualified Medicare infusion therapy provider," the Department of Health and Human Services says in an Aug. 20 release. "Those who fail to reapply within 30 days of receiving a notice to reapply from CMS will have their Medicare billing privileges revoked."

HHS is running the same requirements in an HHA demonstration in Los Angeles and Houston (see Eli's HCW, Vol. XVI, No. 26) and a DME demo in South Florida and Southern California (see Eli's HCW, Vol. XVI, No. 28).

And as with the HHA and DME projects, infusion providers "that fail to report a change in ownership; have owners, partners, directors or managing employees who have committed a felony; or, no longer meet each and every provider enrollment requirement will have their billing privileges revoked," HHS threatens.

Once providers leap the reenrollment hurdle, their trials aren't over. "Infusion providers that successfully complete the reapplication process may be subject to an enhanced review, including site visits," HHS warns.

Much of the fraudulent billing is related to HIV patients treated at infusion clinics, HHS says. One of the main defendants in an alleged fraudulent infusion billing scheme also owns multiple DME companies in addition to the infusion clinic, the release says.