March 9, 2012

Home Healthcare Community Applauds U.S. Representative Charles Boustany for Leading Efforts to Combat Medicare Fraud

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Washington, DC — The Partnership for Quality Home Healthcare today praised Representative Charles Boustany (R-LA), Chairman of the House Ways and Means Subcommittee on Oversight, for his leadership in Congressional efforts to combat fraudulent billing practices within the Medicare program which divert resources from beneficiaries and increase costs borne by taxpayers.

In applauding Rep. Boustany’s action, the Partnership pointed to bold reform proposals, which they have developed to specifically target fraudulent behaviors in areas of the country where fraud and abuse are pervasive. Analyses of Medicare data show that targeting the small number of providers who bill outside national norms would significantly reduce annual Medicare spending. In recognizing this trend, the Partnership has developed targeted reforms that would establish firm limits on episode and low-utilization payments in order to prevent fraudulent activity before it takes place.

“We are grateful for the opportunity to work with leaders like Representative Boustany to advance program integrity reforms which will generate billions in savings and protect seniors and taxpayers alike from those who would manipulate the Medicare and Medicaid programs,” said Billy Tauzin, former House Energy and Commerce Committee chairman and senior counsel to the Partnership for Quality Home Healthcare. “We have made real progress in the fight against fraud and abuse, but much work remains — work that we are committed to helping succeed.”

The home healthcare leader points to recently released data from the Centers for Medicare and Medicaid Services (CMS) showing that a single payment reform relating to outlier claims that was proposed by the home healthcare community in 2009 achieved nearly $1 billion in Medicare savings in 2010 alone — equivalent to nearly $11 billion in savings over the next 10 years. As a result, this policy serves as evidence that targeted program integrity reform can generate significant savings without impacting beneficiaries or cost-efficient providers.

“The skilled home healthcare community is dedicated to improving the program integrity, quality and efficiency of the Medicare and Medicaid programs,” added Eric Berger, CEO of the Partnership. “We are grateful for Congress’ consideration of the solutions we have developed and look forward to helping achieve the significant savings and delivery system improvements that beneficiaries and taxpayers deserve.”

Skilled home healthcare is the most cost-effective clinical care setting available for seniors today. Nearly 90 percent of American seniors prefer to age and receive treatment in their own home. Nationwide, more than 3.3 million Medicare beneficiaries receive skilled home healthcare to treat illnesses related to acute, chronic or rehabilitative needs.