Home Health Leaders Commend Efforts to Combat Waste, Fraud and Abuse in the Medicare Program

August 8, 2014
Contact: Ellen Almond

Home Health Leaders Commend Efforts to Combat Waste, Fraud and Abuse in the Medicare Program

Program integrity measures cited as sustainable approach to Medicare reform instead of arbitrary, across-the-board payment cuts

Washington, DC – The Partnership for Quality Home Healthcare – a leading coalition of home health providers dedicated to improving the integrity, quality, and efficiency of home healthcare for our nation's seniors – today commended House Ways and Means Subcommittee on Health Chairman Kevin Brady (TX- 8) for drafting legislation to support greater fraud prevention programs within the Medicare program.

On Thursday, Chairman Brady released the Protecting Integrity in Medicare Act of 2014 (PIMA), draft legislation to increase efforts to combat Medicare fraud, waste and abuse. The draft legislation includes bipartisan priorities for strengthening the Medicare program by improving efficiencies and reducing fraudulent and wasteful spending.

“We commend Chairman Kevin Brady for seeking solutions that will prevent wasteful spending and protect American seniors,” stated Eric Berger, CEO of the Partnership for Quality Home Healthcare. “We are committed to advancing targeted program integrity solutions, which present a more sustainable approach to reform rather than arbitrary Medicare cuts and higher beneficiary costs that threaten patient access to care.”

Home health leaders have long sought targeted program integrity measures to prevent fraud and abuse. The Partnership has developed a targeted program integrity reform proposal - Skilled Home Health and Integrity Program Savings (SHHIPS) – to prevent payment of aberrant claims by strengthening claims review processes, creating payment safeguards and tightening participation standards, including temporary entry limitations to prevent excess growth.

SHHIPS is based upon a successful policy included in the Affordable Care Act (ACA), which achieved a 70 percent reduction in outlier costs — from $1.2 billion in 2009 to $350 million in 2010 — and is on track to generate a total of $11 billion in taxpayer savings over the next decade. By capping Medicare outlier claims at 10 percent, the policy was effective in stemming what was considered to be unchecked fraud and abuse.

“We applaud Chairman Brady for prompting this important discussion and look forward to working with him and his colleagues in Congress to advance policies such as SHHIPS that are proven to strengthen the delivery of healthcare to our nation’s seniors,” added Berger. “America’s seniors deserve the highest quality, most cost effective, and most secure Medicare program possible.”

Nationwide, 3.5 million senior and disabled Americans rely on the Medicare home health benefit for clinically advanced, cost effective and patient preferred home healthcare.

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