Home Health & Hospice Week

• The public -- and Congress -- are taking notice of Program Safeguard Contractors' track records, and the result could be tougher investigations for you.

Back in May, the OIG issued a report noting PSCs' statistics on topics including overpayment recoupment and fraud case referrals (see Eli's HCW, Vol. XIX, No. 19, p. 151). Now Sen. Charles Gras-sley (R-Ia.) is asking why the recoupment and referral figures are so low.

"Medicare is already a pay-and-chase system when it comes to fraud, waste and abuse," Grassley has told the press. "Providers are paid first, then questioned if there's a problem. Add to that mix contractors who sit on cases of ongoing fraud when they should be referring them to law enforcement, and you have a recipe for disaster."

Zone Program Integrity Contractors (ZPICs) have been replacing the PSCs and are doing a better job, Medicare maintains. "By using these new contractors that can review claims across multiple providers and benefit categories, we will be better able to identify cases of waste, fraud or abuse," says CMS spokesman Peter Ashkenaz. "And, we will be better able to monitor both the ZPICs' overpayment and collection efforts to make sure that they are performing their own oversight responsibilities."