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AAH Responds to CMS ‘Anti-Fraud Measures’

January 9, 2008 by HME Business

A statement from the American Association for Homecare said that it welcomed CMS’s efforts to fight Medicare fraud, but added that “it’s important to note that Medicare has failed to effectively exercise its already ample authority to combat fraud and abuse.”

CMS’s January 8 announcement of the next 70 MSAs for its competitive bidding trial was couched in language now familiar to HME providers asserting that the program is in place to lower prices and protect against fraud.

The association stated that while accreditation is a “time-tested” way to uncover “fraudulent entities,” and that the Medicare Modernization Act (which requires accreditation) was passed in 2003, the Sept. 30, 2009 deadline for accreditation was not announced until several weeks ago.

AAH called for CMS to make better use of its utilization data: “A spike in utilization for a specific DMW item should trigger closer examination,” the AAH statement said.

AAH also asserted that DME and the homecare sector account for less than 2 percent of Medicare’s larger than $400 billion budget. Comparing a 2.3 percent increase in DME spending between 2005 and 2006, against an overall 19 percent jump in Medicare spending for the same period, AAH argued that DME is Medicare is also Medicare’s slowest growing sector.

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