'We want to take the lead to end fraud,' AAHomecare says

Sunday, February 15, 2009

ARLINGTON, Va. - AAHomecare pushed its anti-fraud and abuse plan during a conference call with the media last week. 

"We want the public to understand that AAH wants to take the lead to end fraud in the home medical equipment sector," said Tyler Wilson, AAHomecare's president and CEO.

AAHomecare's plan, released in October, outlines 13 steps to stop HME fraud and abuse. The steps, which focus mostly on new providers, include mandatory site inspections, an improved validation process for obtaining billing numbers, a six-month trial period and additional unannounced site visits.

The plan, AAHomecare believes, would be more effective at eliminating fraud than reimbursement cuts or national competitive bidding, which do nothing but pinch hardworking providers.

"NCB is a price-setting mechanism," Wilson said. "We have supported accreditation and other efforts to prevent fraud over the years, but we maintain our opposition to competitive bidding. It is not a fraud program and we'll argue that it is anti-competitive."

Medicare loses about $60 billion annually to fraud. HME accounts for about $1 billion of that, Wilson said.

"It's a loss by any yardstick, and it's a disgraceful waste of taxpayer dollars," he said. "The tremendous, cost-effectiveness of HME has too often been obscured by a few bad apples."