Association asks CMS to clear up infusion confusion

Sunday, August 26, 2007

ALEXANDRIA, Va. - The National Home Infusion Association (NHIA) wants Medicare to clarify just exactly who it's targeting with its latest anti-fraud effort.

On Aug. 20, the Department of Justice (DOJ), the Department of Health and Human Services (DHHS) and CMS announced a two-year demonstration project that will require infusion providers in South Florida to reapply for their Medicare billing numbers. The program is aimed at weeding out fraudulent providers in the region.

Missing from materials provided was a clear definition of what constitutes "infusion providers." Subsequent media coverage assumed CMS was referring to home infusion providers.

David Franklin, vice president of business operations for Advanced Care Infusion in Shelby Township, Mich., said the confusion affects all infusion providers.

"It paints the (home infusion) industry with a bad brush," said Franklin. "We don't have anything to do with it. There's no home infusion entities involved, no NHIA members involved. We're just concerned with perception."

Industry sources pointed out that examples of fraud given at the conference did not involve home infusion providers. In one high-profile case, the DOJ announced charges against a Miami billing company. Rita Campos Ramirez, owner of Miami-based R and I Medical Billing, was charged with conspiracy to commit healthcare fraud and submission of false Medicare claims, collecting $105 million between 2002 and 2006.

"While we are deeply disappointed that home infusion providers have been inappropriately implicated in the South Florida demonstration, and we urge CMS to correct the public record as soon as possible, we remain committed to working with CMS and other agencies to promote reasonable and effective efforts to eradicate fraud and abuse in the Medicare program," NHIA Executive Director Russell Bodoff said in a statement released Thursday.