Home Health & Hospice Week

Sidestep reputational damage by hopping on the anti-fraud bandwagon.

Smart home care providers will realize the best defense is a good offense when it comes to avoiding fallout from fraud cases such as the one against Dr. Jacques Roy and three associated home health agencies in Dallas.

One tactic to combat the reputational damage from such fraud cases is direct appeal. "This doctor and agencies charged with fraud are the exception, not the rule, and they most assuredly do not characterize home health agencies in San Angelo," says Donna Colley, partner in Medway Home Healthcare in that town, in a letter to the editor of the San Angelo Standard Times. "Our agency is composed of dedicated and caring staff who work in home health because they care for their patients and want to help them remain in their own homes and receive the highest level of care. We continually educate our staff on the qualifications and regulations of the Medicare program. All home health agencies should not be 'painted with the same brush' as this doctor and agencies in Dallas," Colley says in the letter.

Or you can take a page from the national trade associations' playbook. Both the National Association for Home Care & Hospice and the Visiting Nurse Associations of America have applauded the bust and exhorted the feds to take a stronger stance against home care fraud.

The Roy case "should serve as a warning to providers that they will face greater scrutiny," says NAHC's Val Halamandaris. "The end result of all this should be to improve the fiscal integrity of government programs. All in all, this is good news."

"Our agency and staff support any effort to identify and punish the few who abuse the system," Colley says in her letter to the editor.

Both NAHC and the VNAA call for further fraud enforcement action. NAHC wants home health management credentialing and required corporate compliance plans, it says. VNAA proposes a temporary moratorium on new Medicare enrollees for home health and hospice.

"We often hear complaints from nonprofit hospices about patient recruitment and other questionable practices in hospice," VNAA's Andy Carter says in a release. "We believe a temporary moratorium in hospice is also warranted."

As support, Carter cites a February letter from Sens. Orrin Hatch (R-Utah) and Charles Grassley (R-Iowa) that called upon CMS to exercise its authority to impose a temporary moratorium on new Medicare providers and suppliers, specifically home health.