Once again last week, home care was in the news in a major press statement from CMS and on national television. Unfortunately, the stories weren’t about the patients and families receiving incredible comfort and care from our skilled teams, or about hospitalizations prevented, or healing advanced. The news was about the indictment of Dallas physician Jacques Roy – accused of running a 485 factory that “certified more Medicare beneficiaries for home health services and had more purported patients than any other medical practice in the United States.” Dr. Roy allegedly certified or directed the certification of more than 11,000 individual patients from more than 500 HHAs for home health services during the past five years, for services totaling $375 million. Five people have been indicated and Medicare payments to 78 agencies have been suspended.
The Home Care Alliance of Massachusetts has tried to lead when it comes to ensuring an industry that is ethical and trusted by patients and referrals sources. Several years ago, we added a Code of Business Ethics to our membership application. We have taken a strong stand against unchecked growth, supporting language in the Affordable Care Act that gives the federal EOHHS Secretary to impose temporary moratoriums in areas that have sufficient coverage and unsustainable growth. In 2010, we suggested in a letter to Secretary Sebelius that the the 25% growth of new agencies in four years in Mass deserved some EOHHS attention. We have expressed concerns to federal and state regulators about the deemed accreditation process, whereby new agencies gain entry into the market, and about the need to make it more rigorous, We have published – mostly for our referral partners in physicians offices and assisted living – several pamphlets (“Keeping It Legal”) on referrals, kickbacks and other prohibited practices.
This week we in response to the Texas news, the Visiting Nurse Assoiciation of America called on CMS “to use its authority to put a temporary moratorium on home health until better controls to prevent waste, fraud and abuse can be put in place. Enforcement,” VNAA said, “is not enough.”
Next week, the Board of Directors of the Home Care Alliance will be meeting. What do the members think should be our position on the “Texas situation?”