For almost five years now, I have been educating Congress on a number of ways to fight real fraud in the Medicare system. Some of those initiatives include mandatory third party accreditation, increased quality standards and increased, unannounced site visits. I am convinced that there was someone finally listening when I asked the question: how can a dry cleaner or empty building be billing the Medicare program? Can it really be that easy? Shouldn’t we be doing as much as we possibly can to a) protect our most frail population from these scam artists, b) protect the Medicare trust, and c) finally save the integrity of legitimate suppliers who are 100% committed to providing quality healthcare to Medicare beneficiaries?

The power mobility industry has been pushing for true, fraud measures for quite some time. It seems that for every step we take forward in gaining much deserved credibility, another scam artist makes the front page. Quite frankly…it’s time to put an end to this practice. In fact, the American Association for Homecare wrote an open letter to Congress entitled Greater Efforts Needed by Medicare to Combat Fraud applauding the recent efforts by CMS, but that more needed to be done.

Now, The Centers for Medicare and Medicaid Services (CMS) appears to be getting serious about fighting Medicare fraud associated with the power mobility benefit. The agency has recently shifted their focus from measures that restrict access to power wheelchairs and scooters to actually tracking down fraudulent suppliers and putting an end to costly scams that are costing the government millions of dollars.

In a July 2 press conference, Health and Human Services Secretary, Michael Leavitt announced an expansion of the Medicare Fraud Strike Force, a two-year effort designed to further protect Medicare beneficiaries from fraudulent suppliers. The power mobility industry applauds this new direction. Suppliers, manufacturers and Medicare beneficiaries still suffer from the series of regulatory changes — reimbursement cuts, new coding, competitive bidding and others — that were touted by CMS as tough action against fraud. But in most instances, the victims of these policies were legitimate suppliers and beneficiaries, not the scammers.

At least now, CMS has its sights on the right target: the fraudulent dealers. The demonstration project is aimed at South Florida and Los Angeles. Under the initiative, suppliers (about 2,700 in South Florida and 5,000 in LA) must reapply for their National Supplier Clearinghouse (NSC) supplier numbers; these numbers are required to bill the Medicare system. And, suppliers will need to be accredited and CMS will also conduct unannounced site visits.

This is attacking the problem at the source!

I’ll have Part II next time.