Thursday, July 19, 2007

Why new Laws for Fraud Prevention in Los Angeles & Houston ONLY?

Senior Citizen Alerts
Fraud of Senior Citizens by Home Health Agencies is Target for Government Initiative
Initial efforts to focus on Greater Los Angeles and Houston areas

July 17, 2007 – An alarm about fraud of senior citizens by home health care providers was raised today by an announcement that Health and Human Services will begin an initiative designed to protect Medicare beneficiaries from fraudulent Home Health Agency (HHA) providers.

This two-year project will focus on preventing deceptive providers from operating in the greater Los Angeles and Houston areas, according to HHS Secretary Michael Leavitt.

“HHS is working to protect the public from fraud by stopping it before it happens,” Leavitt said.

“Our joint effort with the Department of Justice shows that we have zero tolerance for those who would prey on the system. This demonstration project works to bar unlawful Home Health Agencies from entering the Medicare billing system.”

In May, HHS and the Department of Justice announced the establishment of a multi-agency team of federal, state and local investigators designed specifically to combat Medicare fraud through the use of real-time analysis of Medicare billing.

The HHA project follows the announcement of a demonstration project targeting another high-risk industry, fraudulent billing by suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) in South Florida and Los Angeles. The HHA demonstration is being implemented in the greater Los Angeles and Houston areas, which have shown a high frequency of home health care fraud.

The Centers for Medicare & Medicaid Services (CMS) will now require home health care providers who operate in the greater Los Angeles and Houston areas to immediately resubmit applications to be considered a qualified Medicare HHA.

Those who fail to reapply within 60 days of receiving a notice to reapply from CMS will have their Medicare billing privileges revoked.

Also, home health care providers that fail to report a change in ownership or change of address; have owners, partners, directors or managing employees who have had a felony conviction within the last 10 years; or, no longer meet each and every provider enrollment requirement; will have their billing privileges revoked.

In addition to the reapplication process, the HHA demonstration will require a State survey for any HHA that underwent an ownership change within the last two years.

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