NCAMES advocates for legislative plan to stop Medicare fraud and abuse

April 12, 2010 By: David D. Menzies Category: Health Care, Medical Technology

(Raleigh, N.C.) North Carolina’s leader in home medical equipment advocacy and education, NCAMES, is continuing in its efforts to preserve patient access and quality service by supporting a plan to stop Medicare fraud and abuse. The American Association for Homecare, a national trade association representing thousands of member companies across all 50 states, has developed an Anti-Fraud Legislative Plan proposing 13 tough, targeted recommendations to prevent fraud and abuse in the homecare system before it starts, saving taxpayers’ millions of dollars in criminal prosecution.

“The thorough anti-fraud plan from the American Association for Homecare provides an effective, workable framework for combating Medicare fraud and protecting patients and HME businesses,” Beth Bowen, NCAMES executive director, said.

According to Bowen, her organization provides many ongoing educational and training programs for member companies to pursue licensure and accreditation in addition to keeping-up on regulatory changes.

“Our bylaws are quite clear in our unwavering support for obeying Federal, state and local laws pertaining to our industry,” she said.

Some of the extensive recommendations contained in the American Association for Homecare plan include mandating HME service provider site inspections; requiring a trial period for new providers; increasing penalties and fines for fraud; having the Centers for Medicare & Medicaid Services (CMS) establish a Medicare anti-fraud office; and CMS development of written due process procedures for the Medicare supplier number process, including issuance, denial and revocation of the Medicare supplier number.

“As Health and Human Services Deputy Secretary William Corr said in his March 4th Congressional testimony, health care fraud is a national problem on the rise, and the criminals who perpetrate it have become more organized and sophisticated,” Bowen said, adding, “We believe that the right approach to prevent fraud is to proactively address the service providers themselves to weed-out the criminals, as opposed to focusing on Medicare itself and instituting unnecessary cuts or price controls which just end-up hurting senior citizens and patients in need.”

Bowen went on to say that any improvements in anti-fraud efforts would depend ultimately upon CMS, which bears the responsibility of administering Medicare’s reimbursement programs and using their authority to allow only legitimate providers entry into the industry.

In addition to educating member companies on the 13-point American Association for Homecare anti-fraud plan to improve Medicare for home medical equipment patients, NCAMES has been advocating for H.R. 3790, a bipartisan bill in Congress supported by 185 co-sponsors including nine of 13 North Carolina Congressmen. The bill proactively corrects flaws in the Federal government’s restrictive Medicare bidding program implemented in October 2009 forcing hundreds of North Carolina HME service providers to engage in “suicide bidding,” layoffs, and business contraction to continue serving Medicare beneficiaries in order to avoid closing their doors.

For more information on NCAMES visit www.ncames.org; for details on the American Association for Homecare anti-fraud plan visit www.aahomecare.org/stopfraud.

With close to 300 member companies and growing, the North Carolina Association for Medical Equipment Services (NCAMES) is the statewide leader in preserving access to safe, affordable, and therapeutic home medical equipment. We provide advocacy and education to home medical equipment (HME) providers statewide dedicated to helping North Carolina’s growing senior population and patients of all ages gain more mobility and experience a high quality of life in the comfort and privacy of their own homes. NCAMES was instrumental in passing the nation’s first HME licensure law which has been working to ensure quality home health care since 1995, and fully supports pending legislation H.R. 3790 to continue HME access for patients in need. For more information, visit www.ncames.org or call (919)-387-1221.

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