Home Health & Hospice Week

If Medicare wants to adopt stiffer fraud-fighting activities, it should at least choose ones that work — and that won’t be prior authorization for home health services. So said many commenters on the Centers for Medicare & Medicaid Services’ Feb. 5 proposal for a prior auth demo in five states (see story, p. 114).

“Requiring a prior authorization in order to provide [a] service (not product) to our most ill patients will not affect fraud in any way,” the Michigan commenter stressed. “Fraud is a massive problem and should be tackled using other methods and programs that will not in the meantime hurt or even kill our patients, along with negatively affecting our compassionate and professional clinical staff who are out in the field on the front lines positively impacting our patients’ lives.”

Proposals like these harm the good actors without impacting the fraudsters, many commenters insisted. “Why not target those agencies that continue to commit fraud rather than the entire State or HH industry in general?” asked a Florida commenter.

“Quit targeting everyone when it is only a few that abuse the system,” another commenter criticized.

“Entire states should not be penalized for the few counties of bad actors,” said a Pennsylvania commenter. “Consider using your fraud prevention system and taxpayer money to have sting operations against those who are suspect. Stop painting the entire industry with a broad brush.”