On Wednesday, Rep. Beth Van Duyne (R-Texas) introduced a bill that would increase oversight of Medicare home health and hospice, legislation that was welcomed by the National Alliance for Care at Home (the Alliance).
The Protecting Seniors and Stopping Fraudsters Act is designed to bolster Medicare oversight, crack down on scammers, protect seniors from fraudulent enrollments and improve accountability across the hospice and home health system, according to a statement emailed to Home Health Care News’ sister publication, Hospice News.
“Every single dollar stolen by criminals from Medicare is a dollar ripped away from a vulnerable senior who is just trying to spend their final days in comfort, peace and dignity,” Van Duyne said in the statement. “Americans are disgusted by the heartless actions of scammers treating these vital lifelines as personal ATMs and demand reforms to stop these criminals before they can steal precious taxpayer dollars, thereby further weakening the Medicare system.”
Among the bill’s goals is to build systems to identify bad actors earlier, particularly in geographic fraud hotspots like California, Nevada, Arizona and Texas. It would also focus regulatory action on providers with aberrant billing, discharge, enrollment, or low-quality reporting patterns rather than imposing blanket burdens across the industry, the statement indicated.
If enacted, the bill would increase survey frequency for hospices and home health agencies that are newly enrolled in Medicare, providers with ownership changes or those displaying signs of fraudulent behavior. It would also enhance screening requirements for providers considered to be at “extreme risk” of fraud, including fingerprinting administrators and medical directors and requiring proof of liability insurance.
The legislation would also take steps to improve accountability for accreditation organizations by requiring standardized survey training. It would also mandate notification requirements to alert seniors when they have been enrolled in hospice, with instructions on how to disenroll if fraud or abuse occurs.
The Alliance has endorsed the legislation.
“My bill takes a proactive approach to stop fraud by strengthening oversight of high-risk hospice programs and home health agencies through enhanced enrollment screening, mandating more frequent surveys for new and suspicious providers, establishing stronger accreditation standards, and increasing transparency around enforcement activities,” Van Duyne said in the statement. “The Centers for Medicare & Medicaid Services needs and deserves these measures to fight the continued exploitation of services our seniors rely on.”