Fraud summit: 'We should have been more involved'

Thursday, January 28, 2010

WASHINGTON - Last week's National Summit on Health Care Fraud was billed as "the first national gathering on healthcare fraud between law enforcement and the private and public sectors," but AAHomecare didn't get a seat at the table until the last minute. Even then, the association was shut out of much of the proceedings. Here's what Michael Reinemer, AAHomecare's vice president of communications and policy, had to say about the association's disappointment and what it expects to come out of the summit.

HME News: So AAHomecare had requested to participate, but it was denied?

Michael Reinemer: Yes. They finally said, "OK, you can come in," but we weren't able to participate in the closed-door sessions where they were hammering out how to address the real issues. In other words, we missed out on the substantive discussions where our expertise and our familiarity with the issues would have been useful. If they're going to use HME as exhibit A, and if we're going to be out front and leading the charge for reform, we should have been more involved.

HME: Were other industries allowed to participate?

Reinemer: It's hard to say, because there wasn't a list of participants.

HME: What presentations were you able to listen to?

Reinemer: There were presentations by HHS Secretary Kathleen Sebelius and Attorney General Eric Holder. They focused on two things--law enforcement and real-time audits. There was a lot of talk about real-time audits, which is something that we've proposed. If credit card companies can catch fraud virtually instantly, Medicare ought to be.

HME: Did they mention DME specifically?

Reinemer: Yes. Sebelius did mention that the accreditation and the surety bond requirements are in place now.

HME: What do you expect to come out of the summit?

Reinemer: That's a good question. If we had been in the room, we would know better. I expect it to be along the lines of what they've already talked about, like computer modeling. They know they can't prosecute their way out of this problem; they have to prevent it.

HME: Anything else of interest?

Reinemer: Someone from the OIG made an appeal to the press to keep reporting on this issue, which is distressing, because the press tends to write the same story over and over with old information, and they don't often include the kind of context that we provide.