HOME HEALTH: Grassley, Breaux Introduce Anti-Fraud Bill
The Chair of the Senate Special Committee on Aging, Chuck Grassley (R-IA), and ranking Democrat John Breaux (LA) introduced Medicare home health legislation yesterday that would "scale back one of the most highly touted anti-fraud provisions" included in last year's Balanced Budget Act, CongressDaily/A.M. reports. Portions of the budget legislation required home health agencies to post "surety bonds" of $50,000 in order to participate in the Medicare program, but the Grassley-Breaux bill "scale[s] back" that amount to $25,000. CongressDaily/A.M. reports that many agencies "found it either impossible to obtain the bonds or that they were prohibitively expensive" (Rovner, 5/6). The Baton Rouge Advocate reports that the new legislation requires only new home health agencies to undergo the bonding mandate (McKinney, 5/6). Grassley said, "Our bill gets at the heart of fraud by keeping bad providers out of Medicare in the first place." According to Breaux, "Our bill seeks to inject some common-sense approaches for combating waste and fraud in home health care."
Besides the bond requirement change, the Grassley-Breaux bill also heightens government scrutiny of home health agencies and provides improved screening methods for agency employees before they can enter the Medicare program. Under the legislation, agencies would have to undergo audits if their claims "exhibit unusual features," and would be required to implement fraud and abuse compliance programs and provide greater information to beneficiaries. The bill also creates a task force led by the Health and Human Services Inspector General to study home health agencies, and the legislation would rewrite bankruptcy rules to make it harder for all Medicare providers to avoid penalties and repayment obligations. Breaux said, "By tightening requirements for certification, by improving the way claims are reviewed, and by identifying the cheaters, we will save money in the program and make it better for both beneficiaries and the honest providers." "Fraud and abuse are a pox on the home health care industry. This bill is the vaccine," Grassley said (Aging Committee release, 5/5).