Partnership for Quality Home Healthcare Applauds Senate Finance Committee Leaders for Seeking Program Integrity Improvements

Washington, DC — The Partnership for Quality Home Healthcare commended Senators Orrin Hatch (R-UT), Chuck Grassley (R-IA) and Tom Coburn (R-OK) for urging regulators to increase efforts to combat Medicare waste, fraud and abuse by halting the installment of new providers in areas identified as high-risk to the Medicare program. The lawmakers are urging the Centers for Medicare and Medicaid Services (CMS) to implement the moratorium on providers allowed under the Affordable Care Act (ACA).

In a letter to HHS Secretary Kathleen Sebelius, the Senators write, “HHS and CMS have a duty to ensure that taxpayer dollars are being carefully stewarded and that all available tools are being utilized to combat health care fraud nationwide.”

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 — has long supported program integrity reforms to curb fraud and abuse in the Medicare system and urges increased efforts to strengthen Medicare to prevent fraud and abuse before it occurs for the benefit of patients, honest providers and American taxpayers.

The Partnership has developed a proposal entitled the Skilled Home Health and Integrity Program Savings (SHHIPS) Act to combat the payment of aberrant claims by tightening participation standards, strengthening claims review processes, and creating payment safeguards. The proposal includes provisions creating meaningful entry limitations to prevent excess growth. Under the Partnership’s plan, the HHS Secretary is required to suspend the issuance of new home health provider numbers in counties with an over-saturation of providers, a factor associated with aberrant billing behavior.

“We applaud the Senators’ leadership on this issue and strongly agree that increased program integrity measures are needed to stop the wasteful use of taxpayer dollars,” said Eric Berger, CEO of the Partnership. “Our proposal provides a pro-patient solution that will achieve long term cost-savings and Medicare program sustainability while protecting beneficiaries, compliant providers and taxpayers.”

In its report released last month, MedPAC again confirmed that fraudulent and abusive billing practices in the home health sector are confined to isolated geographic areas of the country. The Commission has identified 25 counties (of the nation’s 3,143 counties) where the highest levels of Medicare billing and suspected abuse are occurring, indicating that Medicare data allows government to identify and target fraudulent acts.

The Partnership is also a founding member of Fight Fraud First!, an organization representing seniors, persons with disabilities, military veterans, and minority communities who advocate for the elimination of fraud and abuse from the Medicare program instead of across-the-board cuts or burdensome copayments that unfairly target seniors and honest providers.