Association chases fraud

Saturday, January 31, 2009

OKEMOS, Mich.--A fraud initiative launched by the Michigan Home Health Association (MHHA) last March picked up steam in December when members gave a presentation on home care to a fraud task force that’s part of the U.S. Attorney General’s office.

“We want them to see what the healthcare industry looks like, how we are regulated, what standards we’re held accountable to,” said Harvey Zuckerberg, executive director. “We also want to tell them why it’s so important to us to root out the unlawful practitioners.”

Creating better public awareness of the industry is just one part of the association’s approach to fighting fraud and abuse, says provider Michael Bartz, association president. The association also wants to help both providers and consumers recognize red flags, he said.

“We don’t want to create a witch hunt,” said Bartz. “We want to let people know what’s right and wrong, and we want providers to report the bad apples.”

To encourage fraud reports, the association has been building relationships with an alphabet soup of agencies, including CMS, the FBI, and the OIG, along with state Medicaid programs and third party private payers. As a bonus, working with those offices offers insight into what providers can expect when they file a complaint, as well as the dollar threshold required to trigger an investigation, said Zuckerberg.

MHHA also wants to serve as a fraud-reporting mechanism, he said.

“Providers can maintain their anonymity and use us to vet their suspicions,” said Zuckerberg. “We will have a qualified process to sort out frivolous complaints from something that may have merit.”

MHHA has 350 members comprised of HME and home infusion providers, hospice agencies and home nurses.

It’s important for all facets of the homecare community to work together, says Bartz.

“We are all taking care of the same patients,” he said.