Home Health Leaders Commend CMS for Extending Medicare Safeguards to Prevent Fraudulent Behaviors

The Partnership for Quality Home Healthcare — a coalition of home health providers dedicated to developing innovative reforms to improve the program integrity, quality, and efficiency of home healthcare for our nation’s seniors — today commended the Centers for Medicare & Medicaid Services (CMS) for further extending safeguards designed to protect Medicare beneficiaries, prevent fraudulent behavior and save taxpayer dollars.

On July 29, CMS will extend the moratoria on the enrollment of home health agencies in the Medicare program by another six months in the metropolitan areas of Miami-Dade, Fort Lauderdale, Detroit, Dallas, Houston and Chicago. Data show that many of these geographic areas have historically been hotspots for fraud and abuse.

“We commend CMS’ continued efforts to prevent fraudulent activity within the Medicare program and support targeted reforms to prevent aberrant behaviors that put Medicare’s most vulnerable patient population at risk,” stated Eric Berger, CEO of the Partnership for Quality Home Healthcare. “The Partnership is committed to advancing targeted program integrity solutions, which present a more sustainable approach to reform rather than arbitrary Medicare cuts and higher beneficiary costs that threaten patient access to care.”

The Partnership has developed a targeted program integrity reform proposal – Skilled Home Health and Integrity Program Savings (SHHIPS) – to prevent payment of aberrant claims by strengthening claims review processes, creating payment safeguards and tightening participation standards, including temporary entry limitations to prevent excess growth. SHHIPS also includes important credentialing requirements, criminal background checks, and a compliance program modeled on the Inspector General’s guidelines.

The Partnership is also a member of Fight Fraud First!, a coalition formed to urge action to combat Medicare waste, fraud and abuse, rather than across-the-board cuts which impact innocent seniors and compliant providers.