ABOUT AAHOMECARE

The American Association for Homecare (AAHomecare) is the national association representing durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) suppliers, manufacturers, and other stakeholders in the homecare community. Our members are proud to be part of the continuum of care that assures beneficiaries and other end users receive cost e ective, safe, and reliable home care products and services. 

AAHOMECARE SUPPORTS EFFORTS TO COMBAT FRAUD & ABUSE

AAHomecare strongly supports the ability of the federal government to implement real time monitoring of submitted claims to detect potentially aberrant or abusive behavior. The banking industry utilizes a model of fraud detection that monitors consumer banking activity to detect unusual activity in real time. The Medicare program should adopt similar types of fraud detection technology.

AAHomecare has long supported federal government initiatives to better monitor DME supplier billing practices and trends. Those recommendations include:

• Enhanced oversight of new suppliers: Increased monitoring and scrutiny of claims submitted by DME suppliers who are new to the Medicare program.
• Monitoring suppliers entering the market for new product categories: Increased monitoring and scrutiny of claims submitted by DME suppliers that submit claims for new product categories.
• Tracking claim volume spikes: Close monitoring of significant increases or spikes in claims submissions for a specific product category over a short period of time.
• Expanding ePrescribing adoption: Strengthening the use of electronic prescribing between physicians and suppliers (ePrescribing) to enhance the legitimacy and verifiability of prescriptions, improving patient safety and enabling payers to better identify and prevent abusive billing practices.

AAHomecare fully supports increased e orts to monitor, detect, and eradicate fraudulent Medicare billings but urges policy makers to ensure that those e orts do not jeopardize beneficiary safety and access to medically necessary items and services. Safeguards must also be in place to prevent undue penalties on DMEPOS suppliers who are furnishing care based on valid physician orders and in accordance with medical necessity.