I am reporting from the National Alliance for Care at Home conference in Washington, D.C.
Last evening’s keynote, the event’s first, featured a panel discussion with Kimberly Brandt, deputy administrator and COO of the U.S. Centers for Medicare & Medicaid Services (CMS), as well as Joel Wherley, CEO of VITAS Healthcare and Denis Fleming, chief government affairs officer for the Alliance.
I have some thoughts. But before I get into that, you can see our coverage of Brandt’s comments on Hospice News.
First, Brandt acknowledged that some legitimate hospices would inevitably get caught in the regulatory crossfire. We have covered this at Hospice News as well.
She pointed to several measures of success in CMS’s battle against fraud:
To date, during the six-month enrollment freeze, CMS has denied 50 hospice and 250 home health applications.
CMS has suspended payments for 899 hospice and home health providers, with 812 of those located in California. This totals $1.4 billion in suspended payments.
The agency has revoked the Medicare enrollment of 761 providers.
What we don’t know definitively is how many of honest hospices were affected, and how many of the guity providers got a payment suspension, revocation or that were blocked from expansion by the current moratoria.
Maybe CMS has data or some way of tracking this that the agency hasn’t discussed publicly. I would wager an educated guess that they don’t know either, at least not the full scope.
The unanswered question is: How many of those companies had actually committed fraud? The answer is we just don’t know.