[Congressional Record Volume 144, Number 11 (Thursday, February 12, 1998)]
[Senate]
[Page S716]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PREVENTING FRAUD AND ABUSE WITHIN THE MEDICARE PROGRAM
Ms. COLLINS. Mr. President, as the Congress grapples with the problem
of maintaining the solvency of the Medicare program and with proposals
to expand Medicare coverage, we must not overlook a critical problem
that threatens the financial integrity of this vital social program,
which provides health care services to 38 million older and disabled
Americans. I am talking, Mr. President, about the problem of waste,
fraud and abuse in this program.
The Permanent Subcommittee on Investigations, which I chair, has
undertaken an extensive investigation into Medicare fraud.
At our first hearing last summer, we learned from the inspector
general of the Department of Health and Human Services that an
astounding $23 billion a year is lost to waste, fraud, abuse and other
improper payments.
In more recent hearings, Mr. President, we discovered that career
criminals, with absolutely no background in health care, were able to
be certified as Medicare providers and enter the system for the sole
purpose of ripping it off.
For example, one case that the subcommittee investigated involved a
totally fictitious durable medical equipment company that was located
in the middle of the runway of the Miami International Airport, if it
had in fact existed.
I am not talking here, Mr. President, about legitimate providers or
innocent mistakes or honest billing errors. I am talking about outright
fraud. We need to do a better job of screening providers and
controlling their entry into the Medicare system.
Mr. President, the vast majority of health care professionals are
dedicated and caring individuals who deliver vital services to millions
of Americans across the country. They are as appalled by this kind of
fraud as any of us.
Recently, I met with the members of the Home Care Alliance of Maine
concerning the issue of fraud in the health care industry. The Home
Care Alliance of Maine has a longstanding commitment to ensuring the
highest quality home health care in the State of Maine. It has adopted
a policy of zero tolerance on fraud and abuse in the home health
industry. Its members recognize that unscrupulous home health providers
not only tarnish the reputation of legitimate health care
professionals, but that these unscrupulous individuals jeopardize the
very availability of Medicare.
I ask unanimous consent the position statement of the Home Care
Alliance of Maine be printed in the Record so my colleagues and
organizations representing home health care agencies across the United
States can have the benefit of the very fine work this organization has
done.
There being no objection, the material was ordered to be printed in
the Record, as follows:
Medicare Fraud and Abuse
position statement
The Home Care Alliance of Maine membership has a long-
standing commitment to provide the highest quality of care to
the elderly and infirm of our state. Even one unscrupulous
home health provider that fails to maintain the values and
ethics that are at the core of home care jeopardizes the
viability of ongoing access to appropriate home health
services.
We recognize that the responsibility for resolving concerns
of fraud and abuse lies with the government, the home health
industry, and individual providers. We further believe that
different strategies are needed to clearly distinguish
deliberately fraudulent practice from unintentional errors
that can occur in the interpretation of the complex and often
vague rules and regulations in the Medicare home health care
benefit.
The Home Care Alliance of Maine firmly believes that fraud
and abuse can be eliminated and errors corrected when
addressed by comprehensive and concerted efforts among the
industry, government, individual providers, and consumers.
This partnership is critical to achieve the mutually
beneficial goal of assuring integrity in administration of
the Medicare home health care benefit.
We further believe that education of consumers and advocacy
groups is central to ensuring trust in legitimate providers
of home health services. It is only through open and public
discussion about the basic structure of changes in the
Medicare home health care benefit that consumers and others
can confidently distinguish blatant fraud and abuse from
innocent errors in interpretation and provision of services.
Informed consumers and their advocates can then be reassured
by their choice of licensed and certified home health
agencies.
The Home Care Alliance of Maine supports:
1. Zero tolerance for fraud and abuse of the Medicare home
health care benefit.
2. Total cooperation with prompt and responsible
investigation and resolution of any errors in interpretation
and application of the Medicare home health care benefit.
3. Medicare coverage and reimbursement standards in
language that is understandable and readily accessible to
providers and consumers through various means, e.g. federal
depository libraries, state regulatory agencies, trade
associations, fiscal intermediaries, and the Internet.
4. Enhancement of education and training of home health
agencies through joint efforts with regulators.
5. Credentialing and competency testing standards for
government contractors and federal regulators responsible for
issuing Medicare determinations.
6. Mandatory screening and background checks on all
applicants for Medicare certification as a home health
agency.
7. Development and provision of a summary of program
coverage requirements for consumers and prospective consumers
of Medicare home health care benefits.
8. Enhancement and increased accessibility of the consumer
reporting hotline for suspected fraud and abuse.
The Home Care Alliance of Maine is committed to working
with its membership, state and federal regulatory bodies, and
consumer advocacy groups to ensure the integrity of the
Medicare home health care benefit in Maine.
Ms. COLLINS. I appreciate the opportunity to comment on this issue.
I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The legislative clerk proceeded to call the roll.
Mr. COVERDELL. Mr. President, I ask unanimous consent that the order
for the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
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