Home Health & Hospice Week

Expect hearings over Medicare suspensions to get tougher in the wake of an Associated Press story critical of the process. Regulators fighting up to $90 billion a year in Medicare fraud "frequently suspend Medicare providers, then quickly reinstate them after appeals hearings that government employees don't even attend," the AP story notes. Although the quick reinstatements have been a godsend for legitimate providers who are wrongly accused or are accused of minor violations, they have been an unfortunate symptom of the clogged system when dealing with fraudsters that bilk the Medicare system out of money.

The problems are rooted in "poor communication between one set of contractors paid to inspect Medicare providers and alert officials to suspicious activity; a separate set of contractors that handles payments; and the agency that runs Medicare," the analysis notes. CMS reps did not explain to the AP why they didn't show up at many of the hearings, the article notes.