HME’s two-part challenge: Report fraud, tell story

WATERLOO, Iowa – VGM Government Relations has reintroduced a fraud resource center to make it easier for industry stakeholders to help remove bad actors from the home medical equipment (HME) industry. But Ike Isaacson, senior vice president of government and regulatory relations, wants to be clear: The industry wants to not only acknowledge fraud in the Medicare program but also recognize the good actors that make up most of the industry.

HME News: The Centers for Medicare & Medicaid Services (CMS) implemented a six-month moratorium on new Medicare enrollments for DMEPOS providers in late February. Shortly after, VGM reintroduced its fraud resource center, which includes direct links to federal and state reporting pages. Why?

Ike Isaacson: I want people to feel comfortable starting the process of making the federal government and the states aware. The message is not: It’s your job to investigate. But – and I hate this saying, because it’s cliché – if you see something, say something. If we can make that process easier, we’ll continue to weed out the folks who are suspect.

HME: What is the impact of the increased spotlight on fraud in HME right now?

Isaacson: It’s creating an environment of distrust and skepticism, while our members are the gold standard, the people who are doing it right every day. It creates barriers to patients, which is one of my frustrations.

HME: How should the industry on the one hand help to reduce fraud and on the other hand, kind of, stick up for itself?

Isaacson: In every venue I can, I’m saying, “We don’t want this stuff going on, either; but let’s also recognize the amazing value and efficacy that our members provide.” I see our role as, report fraud but also on top of that, tell our story. It’s not just on a legislative level. There are so many civic organizations, so you can make sure your community knows what you’re doing and how you’re a resource. It’s a two-part challenge.

HME: How do providers tell their story?

Isaacson: It has to be part of your operating plan; it has to be part of your day to day. You have to be a storyteller. Also, you have to work alongside VGM, AAHomecare, NCART, CQRC – the industry organizations – to make sure you’re highlighting all the amazing work you’re doing.

HME: What’s the story that’s most important to tell?

Isaacson: How much you save the health care system overall. If you’re not there, where are these people going – they’re going into skilled-nursing facilities, into hospitals, generally higher-acuity, higher-pay services. And that speaks to the priorities of the administration – cost savings, better health outcomes.

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