[Congressional Record Volume 144, Number 56 (Thursday, May 7, 1998)]
[Senate]
[Pages S4488-S4489]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             HOME HEALTH INTEGRITY PRESERVATION ACT OF 1988

  Mr. GRASSLEY. Mr. President, yesterday, I introduced Senate Bill 
2031, the Home Health Integrity Preservation Act of 1998. I am pleased 
that Senator Breaux cosponsored this bill. This legislation will be an 
important tool in combating the waste, fraud and abuse that has 
threatened the integrity of the Medicare home health benefit.
  Although the majority of home health agencies are honest, legitimate, 
businesses, it is clear that there have been unscrupulous providers. 
Last July, the Senate Special Committee on Aging, which I chair, held a 
hearing on this topic. The hearing exposed serious rip-offs of the 
Medicare trust fund, and highlighted areas that need more stringent 
oversight.
  In response to the hearing, Senator Breaux and I followed up with a 
roundtable discussion on home health fraud. The roundtable brought 
together key players with a variety of perspectives. Participants 
included law enforcement, the Administration, and the home health 
industry.
  The roundtable yielded a number of proposals which were shaped into 
draft legislation and circulated to a wide variety of stakeholders. In 
response to comments, the draft was changed to address legitimate 
concerns that were

[[Page S4489]]

raised. The result is a balanced piece of legislation that includes 
important safeguards against fraud and abuse of the system, but does 
not stifle the growth of legitimate providers.
  The Home Health Integrity Preservation Act of 1998 would do the 
following: It would modify the surety bond requirement in the BBA so 
that only new agencies need to obtain surety bonds. Because HCFA's 
surety bond rule goes far beyond Congress's intention to keep bad 
providers from entering Medicare, many existing agencies with no 
history of fraud have been unable to obtain bonds. This provision would 
force HCFA to return to Congress's original intention. It also reduces 
the amount of the bond needed to $25,000.
  It would heighten scrutiny of new home health agencies before they 
enter the Medicare program, and during their early years of Medicare 
participation.
  It would improve standards and screening for home health agencies, 
administrators and employees.
  It would require audits of home health agencies whose claims exhibit 
unusual features that may indicate problems, and improve HCFA's ability 
to identify such features.
  It would require agencies to adopt and implement fraud and abuse 
compliance programs.
  It would increase scrutiny of branch offices, business entities 
related to home health agencies, and changes in operations.
  It would make more information on particular home health agencies 
available to beneficiaries.
  It would create an interagency Home Health Integrity Task Force, led 
by the Office of the Inspector General of Health and Human Services.
  It would reform bankruptcy rules to make it harder for all Medicare 
providers, not just home health agencies, to avoid penalties and 
repayment obligations by declaring bankruptcy.
  This legislation is an important step in ensuring that seniors 
maintain access to high quality home care services rendered by 
reputable providers. I urge my colleagues to join me in this effort by 
cosponsoring this important legislation.

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