Fraud: AAHomecare fights, government probes

Sunday, December 7, 2008

WASHINGTON - AAHomecare last week hired Rational PR, a Washington, D.C.-based public relations firm, to help combat misconceptions about fraud and abuse in the HME industry.

"We need to make sure the public and policymakers are aware that we're in front of the issue and that the homecare sector is trying to solve this problem," said Michael Reinemer, AAHomecare's vice president of communications and policy.

For now, Rational PR will focus on generating news articles that highlight efforts to combat fraud like AAHomecare's 13-point plan. The plan outlines steps like mandating site inspections for new providers, establishing a Medicare anti-fraud office and implementing real-time claims analysis.

AAHomecare believes Rational PR, a "small firm with big talent" and strong Capitol Hill connections, will get the job done.

"Three of their staff members are former communications directors in U.S. Senate offices," he said. "They have experience developing press and media strategies related to policy issues in Washington."

In addition to hiring Rational PR, AAHomecare has begun meeting with CMS and Congress to discuss its 13-point plan.

"We don't think these are overly complicated provisions," said Walt Gorski, AAHomecare's vice president of government affairs. "They bring fraud detection into the 21st century by putting forth mechanisms to identify aberrant billing patterns or things that just shouldn't happen."

OIG probes family ties
WASHINGTON - The OIG suspects that some DMEPOS providers with outstanding Medicare debt may be still receiving payments through businesses fronted by associates or family members, the agency stated in a recent "early alert" memo. In a probe of 10 Texas providers with a total outstanding Medicare debt of $7.3 million, the OIG found six were associated with 15 other providers and home health agencies that received $58 million in Medicare payments from 2002 to 2007. Most of the providers that were investigated had $6.2 million in Medicare debt and lost their billing privileges by January 2005. To read the OIG's report: