The OIG report issued today is a portfolio of the series of Medicaid home care related reports previously issued by the OIG. Among the most significant concerns expressed by the OIG is the fraudulent billing for services by individual caregivers employed by the Medicaid beneficiaries. “Self-directed care is an essential part of home care for the elderly and persons with disabilities. CMS and the states need to take all reasonable steps to curtail any abuses to protect this valuable care,” stated Halamandaris.
“The report includes references to earlier findings of abuses and risk areas in both self-directed care and care provided by home care agencies” stated David J. Totaro, Chair, National Council on Medicaid Home Care, an affiliate of the National Association for Home Care & Hospice. Totaro noted that there are concerns common to both delivery models, but there are distinctions that need to be considered as well. He stated that, “the program integrity solutions need to be tailored and targeted to fit the particular concern. We are ready to help CMS and the states develop the right solutions to ensure program integrity.”
NAHC has always had a zero-tolerance policy for those who would look to divert funds from Medicare or Medicaid for their own personal gain. We have taken a very focused and aggressive approach to fraud concerns in home health care. “The fraud committed by the very few, hurts all of home care and the patients we serve. The industry must be a leader in in health care compliance and program integrity. NAHC has made great progress in that regard and will continue to set the gold standard for all of health care,” stated Halamandaris.
Mr. Halamandaris served as Counsel to the U.S. Senate and House Committees on Aging for some 20 years. Before coming to NAHC as its CEO in 1982, he helped write the laws creating the Office of Inspector General in the Department of Health & Human Services, making Medicare and Medicaid fraud a felony, outlawing kickbacks, upgrading the mail fraud statute, and creating state Medicaid fraud units.
The National Association for Home Care & Hospice (NAHC) is a nonprofit organization that represents the nation’s 33,000 home care and hospice organizations. NAHC also advocates for the more than two million nurses, therapists, aides and other caregivers employed by such organizations to provide in-home services to some 12 million Americans each year who are infirm, chronically ill, and disabled. Along with its advocacy, NAHC provides information to help its members provide the highest quality of care and is committed to excellence in every respect. To learn more about NAHC, visit www.nahc.org.
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