Last week, governmental officials announced the largest-ever crackdown on suspected Medicare fraud. More than 200 people are being charged in alleged false billing, amounting to around $712 million. This latest sweep by the nation’s Strike Force against Medicare fraud included 46 doctors, nurses and other medical professionals, according to U.S. Attorney General Loretta Lynch and FBI Director James Comey.
The suspects “billed for equipment that wasn’t provided, for care that wasn’t needed, and for services that weren’t rendered,” said Lynch.
Officials attributed last week’s arrests, in large part, to ‘the increasing sophistication of computer programs that detect patterns of potential fraud, triggering investigations.’
The June 18th announcement should have caused every healthcare provider to stop and assess their fraud prevention capabilities. While all sectors of healthcare are targets for fraud, home health is unique in that the healthcare clinician provides care by visiting the patient in the home.
While advancements in technology are bolstering the government’s efforts to identify potential Medicare fraud, advancements in technology are also helping home health agencies protect themselves from fraud by a disreputable care giver.
An advanced technology solution now provides proof that care was actually delivered in the home as part of the submitted claim. Electronic Visit Verification is a mobile software technology platform that electronically verifies that service visits occurred and documents the precise location of the clinician. This technology verifies that patients are receiving the services authorized for their plan of care and for which Medicare is being billed.
This ‘verification’ can be obtained with an app on a mobile device such as a SmartPhone or tablet to document that the clinician actually delivered care at the patient’s home. The app captures the GPS location and date and time stamps the record when the clinician checks-in and checks-out for the visit. The patient’s electronic signature is also captured to document the visit took place.
With the government Task Force uncovering and charging providers with healthcare fraud nearly weekly – who will be next? Don’t let it be your home health agency. A criminal charge of Medicare fraud would jeopardize your business, your livelihood, your reputation, and your freedom. Operators would be wise to take every measure of fraud prevention, including adoption of Electronic Visit Verification.