Partnership for Quality Home Healthcare Applauds Public-Private Partnership to Eliminate Healthcare Fraud

WASHINGTON — Following today’s announcement of a public-private partnership designed to eliminate healthcare fraud, members of the home healthcare community commended the U.S. Department of Health and Human Services (HHS) and the Office of the Attorney General for their efforts to strengthen the integrity of the U.S. healthcare system and stem the loss of taxpayer dollars to fraud and abuse.

The initiative is designed to share information and best practices in order to improve detection and prevent payment of fraudulent health care billings as well as reveal and halt scams that cut across a number of public and private payers.

The Partnership for Quality Home Healthcare (Partnership), a national coalition representing more than 1,500 skilled home healthcare agencies working to help ensure access to quality home healthcare services for all Americans, is a strong proponent of protecting patients and taxpayers alike by preventing fraud and abuse before payment of aberrant claims is made.

In a June letter to the Senate Finance Committee, members of the Partnership wrote: “Fraud and abuse have long plagued the Medicare and Medicaid programs, and although traditional efforts to curb such problems have had a measurable effect, bad actors continue to find a way to enter virtually every segment of these programs, prey on beneficiaries, and make off with billions of taxpayers’ hard-earned money”¦Partnership members have been working together for more than a year to develop policy solutions that we firmly believe will effectively combat fraud and abuse in the Medicare and Medicaid programs. Just as important, the targeted program and payment integrity reforms”¦have been designed to protect beneficiaries, cost-efficient providers and taxpayers alike by preventing fraud and abuse before it begins.”

Policies developed by the home health community have already proven successful in stopping fraud and abuse by preventing fraudulent Medicare payments before they take place. In 2009, the home healthcare community proposed a 10 percent cap on Medicare outlier claims to stem aberrant billing practices that were believed to be evidence of unchecked fraud and abuse. By preventing aberrant claims from being paid in the first place, home healthcare providers envisioned successfully replacing the troubled “pay and chase” practice with a simple and logical “aberrant payment prevention” mechanism. In just one year, this policy resulted in $853 million in savings — an estimated $11 billion savings over 10 years.

“Medicare fraud in home healthcare is a targeted problem that demands a targeted solution,” stated Senator John Breaux, a senior adviser to the Partnership. “The home healthcare community has advanced reforms that would target fraud, protect beneficiaries and taxpayers, and strengthen the integrity of the Medicare home health benefit as a whole. For the sake of the seniors and disabled Americans who depend on skilled home healthcare services, it is critical that we stop healthcare fraud before Medicare beneficiaries are asked to pay more for their care or across the board cuts are imposed on honest providers.”

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The Partnership for Quality Home Healthcare was established in 2010 to assist government officials in ensuring access to quality home health services for all Americans. Representing more than 1,500 skilled home healthcare agencies nationwide, the Partnership is dedicated to developing innovative reforms to improve the quality, efficiency and integrity of home healthcare for seniors and disabled Americans. To learn more, visit www.homehealth4america.org. To join the home health policy conversation, connect with us on Facebook, Twitter and our blog.