Miami: Medicare Fraud Summit Preventing Health Care Fraud

IT'S MY PLEASURE TO INTRODUCE OUR PANELISTS THIS
MORNING. THE FIRST PERSON NEAREST TO ME
RIGHT NOW IS LOU MORRIS WHO IS THE CHIEF COUNCIL TO THE
INSPECTOR GENERAL, THE DEPARTMENT OF HEALTH AND HUMAN
SERVICES AND ONE OF OUR CLOSE PARTNERS WITH OUR WORK AT CMS IN
FIGHTING FRAUD. KNOCKS HIM IS DR. PETER WISE MAN
WHO IS A PRACTICING PHYSICIAN HERE IN THE MIAMI AREA, A
ENDOCRINOLOGIST. NEXT TO HIM IS KATHY,
VICE PRESIDENT FOR FINANCIAL SERVICES OF THE FLORIDA HOSPITAL
ASSOCIATION. AND AT THE FAR END IS SOMEONE
THAT WE ALSO WORK VERY CLOSELY WITH, LEWIS, WHO IS THE
EXECUTIVE DIRECTOR OF THE NATIONAL HEALTH CARE ANTIFRAUD
ASSOCIATION. SO IF YOU WILL JOIN ME IN
WELCOMING ALL OF MY COLLEAGUES, I WOULD JUST REMIND THEM --
[APPLAUSE] THANK YOU VERY MUCH.
I NEED TO REMIND MY COLLEAGUES THAT WE HAVE A VERY TIGHT
TIMEFRAME AND SO WE ARE GOING TO HAVE A TIMER WHO WILL BE WALKING
BACK AND FORTH WARNING THEM WHEN THEIR TIME IS UP.
SO, WITH THAT, WE'LL START OFF AND LOU MORRIS, THE CHIEF
COUNCIL TO THE INSPECTOR GENERAL WILL START OFF.
LOU? -- THANK YOU VERY MUCH.
GOOD MORNING, EVERYONE. IT'S A REAL TREAT TO BE HERE.
I REPRESENT THE OFFICE OF INSPECTOR GENERAL AND THE CHIEF
COUNCIL AND AS YOU MAY KNOW, THE OIG HAS 1,500 MEN AND WOMEN
SPREAD THROUGHOUT THIS COUNTRY WHOSE CORE MISSION IS TO PROTECT
THE INTEGRITY OF THE MEDICARE PROGRAM AND ITS BENEFICIARIES.
WE SPEND EXTENSIVE RESOURCES THIS MORNING GOING OUT
THROUGHOUT THE COUNTRY ARRESTING THOSE WHO PREY ON OUR PROGRAM.
WE ARE ALSO COMMITTED TO COMPLIANCE BECAUSE WE BELIEVE
THAT THE VAST MAJORITY OF PROVIDERS AND SUPPLIERS AND
PHYSICIANS WHO PARTICIPATE IN OUR PROGRAM ARE COMMITTED TO THE
BEST INTEREST OF OUR BENEFICIARIES.
AND SO IT'S A REAL PRIVILEGE TO BE SPEAKING TO YOU TODAY.
YOU KNOW, I OFTEN SPEAK TO GROUPS LIKE THIS AND RECENTLY I
WENT OUT TO THE GIVE AN ADDRESS. I DIDN'T PAY CLOSE ATTENTION WHO
PROI WAS SPOKING WITH SO I HAD MY STERN LAW ENFORCEMENT
LECTURE. I WAS GOING TO TEMTELL THEM WHAT
WAS UP. IT WAS A ROOM FULL OF NUNS.
I HAD NOT PAID CAREFUL ATTENTION TO THE FACT THAT I WAS
ADDRESSING THE CATHOLIC HOSPITAL ASSOCIATION.
AND SO IN A SENSE, I FEEL LIKE ONCE AGAIN I'M PREACHING TO THE
CHOIR, THAT EVERYONE IN THIS ROOM SHARES OUR COMMITMENT TO
PROTECTING THE INTEGRITY OF OUR PROGRAM.
I'M GOING OFFER YOU THREE THOUGHTS, THREE WAYS YOU CAN
PREVENT FRAUD. AND I'M BETTING THAT YOU'RE
ALREADY DOING THOSE. SO IF YOU WILL, FORGIVE ME FOR
STATING WHAT YOU ALREADY KNOW. FIRST STEP, UNDERSTAND AND
COMPLY WITH THE LAW. THERE ARE A LOT OF LAWS OUT
THERE INTENDED TO PREVENT FRAUD IN THE NATION'S HEALTH CARE
SYSTEM. THERE ARE CRIMINAL LAW THAT IS
MAKE IT ILLEGAL TO BILL FOR MEDICALLY UNNECESSARY SERVICES
AND MAKES IT ILLEGAL TO SEEK REIMBURSEMENT FOR SERVICES AND
NOT PROVIDED AS CLAIMED. AND ILLEGAL TO TAKE KICKBACKES
TO GET MEDICARE REFERRALS. THERE ARE CIVIL LAWS WHICH
SANCTIONS ANYONE WHO KNOWINGLY PREVENTS A FALSE CLAIM TO THE
UNITED STATES AND THERE ARE FINES UP TO $11,000 PER FALSE
CLAIM PLUS DAMAGES. WE ALSO HAVE ADMINISTRATIVE LAWS
THAT PROVIDE WITH FRAUD FIGHTING TOOLS.
WE HAVE THE AUTHORITY TO EXCLUDE PARTICIPANTS FROM MEDICARE AND
MEDICAID IF THEY ABUSE OUR PROGRAM OR ITS BENEFICIARIES.
WE ALSO HAVE ADMINISTRATIVE MONETARY PENALTIES THAT LEACH
EVERYTHING FROM THIS VISION OF FALSE CLAIM TO KICKBACKS.
NOW WE ARE GOING TO BE GETTING INTO MORE DETAIL ABOUT THESE
LAWS THIS AFTERNOON. BUT I THINK I CAN OFFER A SIMPLE
TEST THAT YOU CAN USE TO ENSURE THAT YOU UNDERSTAND AND COMPLY
WITH THE LAW. WE CALL IT THE NEWSPAPER TEST.
DON'T DO ANYTHING THAT YOU WOULDN'T HAVE APPEAR ON THE
FRONT PAGE OF THE MIAMI HAROLD. IF YOU USE THAT SIMPLE TEST, I
THINK WILL YOU PASS THE FIRST STEP IN UNDERSTANDING AND
COMPLYING WITH THE LAW. THE SECOND STEP, CREATE A
CULTURE OF COMPLIANCE. AN EFFECTIVE COMPLIANCE PROGRAM
HELPS HEALTH CARE PROVIDERS. IT HELPS IMPROVE PROGRAM RULES,
HELPS IDENTIFY OVER PAYMENTS AND UNDER PAYMENTS.
HELPS RESOLVE POTENTIAL PROBLEMS QUICKLY AND MINIMIZES THE RISK
OF WHISTLE BLOWERS AND MOST IMPORTANTLY, AN EFFECTIVE
COMPLIANCE PROGRAM HELPS YOU SLEEP BETTER AT NIGHT.
NOW COMPLIANCE PROGRAMS ARE GOING TO BE REQUIRED OF ALL
MEDICARE PROVIDERS VERY SOON. SO ONE OF THE THINGS WE WILL
TALK WITH YOU ABOUT THIS AFTERNOON ARE WHAT ARE THE
CRITICAL ELEMENTS OF THE COMPLIANCE PROGRAM?
AND THE INSPECTOR GENERAL'S OFFICE USUALLY HAS SUBSTANTIAL
RESOURCES TO THIS AREA AND WE LOOK FORWARD TO SHARING SOME OF
THOSE INSIGHTS WITH YOU. AND WHAT IS MY THIRD AND FINAL
STEP? TO BECOME A PARTNER IN FIGHTING
THE HEALTH CARE FRAUD BY SELF DISCLOSING PROBLEMS TO THE
GOVERNMENT. AN EFFECTIVE COMPLIANCE PROGRAM
PROMOTES A CULTURE OF INTEGRITY. IT TRAINS EMPLOYEES HOW TO
CONFORM TO PROGRAM RULES AND REGULATIONS.
AN EFFECTIVE PROGRAM ALSO INSURES THAT THERE ARE
INTENTIONAL AUDITS FROM BILLINGS AND OTHER REQUIREMENTS.
IF YOU ARE DOING ALL THOLES THOSE THINGS, IT'S INEVITABLE
YOU WILL FIND BILLING ERRORS, EMPLOYEE MISCONDUCT AND MAYBE
EVEN FRAUD IN YOUR COMPANY OR HEALTH CARE SYSTEM.
NOW THE LAW REQUIRES THAT YOU RETURN THOSE GOVERNMENT FUNDS
THAT YOU'RE NOT ENTITLED TO AND ETHICS TELLS YOU YOU SHOULD BE
RETURNING THINGS THAT DON'T BELONG TO YOU AS WELL.
AND HIDING THE PROBLEM WON'T WORK AND ONLY PROVIDE A BREEDING
GROUND FOR WHISTLE BLOWERS. THE INSPECTOR GENERAL'S OFFICE
SET UP A SELF DISCLOSURE PROTOCOL TO ENCOURAGE PROVIDERS
THAT IDENTIFIED PROBLEMS TO COME FORWARD AND WORK WITH US TO GET
THE PROBLEMS RESOLVED QUICKLY. CMS ALSO DEVELOPING A SELF
DISCLOSURE PROGRAM BECAUSE IT ALSO BELIEVES THAT WE SHOULD BE
PARTNERING AND IDENTIFYING PROBLEMS PROPERLY.
SO WE LOOK FORWARD TO WORKING WITH YOU ON THOSE PROBLEMS AND
LOOK FORWARD TO TODAY'S CONFERENCE AND GETTING YOUR
INSIGHTS ON HOW TO MAKE OUR MISSION EFFECTIVE AND THANK YOU
FOR YOUR TIME. [APPLAUSE]
-- THANK YOU, PETER. GOOD MORNING TO ALL OF YOU.
I COULDN'T HELP BUT NOTICE THE IRONY IN YOU BRINGING THE HEAT
PROGRAM TO MIAMI. AND I WISH YOU THE SAME SUCCESS
AND VISIBILITY AS PAT RILEY BROUGHT TO US.
MY PERSPECTIVE IS DIFFERENT AND MOST OF THE PEOPLE ON THIS
PANEL, I'M NOT AN ORGANIZATIONAL PERSON.
I'M A PRACTICING PHYSICIAN. BUT I FEEL VERY STRONGLY THAT WE
HAVE A VERY IMPORTANT ROLE IN HELPING TO REALLY SOLVE THIS
PROBLEM. IF I COULD HAVE MY FIRST SLIDE.
I JUST WANT TO OUTLINE SOME OF THE THINGS THAT I THOUGHT
PHYSICIANS AND PROVIDERS COULD DO AND WHY PHYSICIANS SHOULD BE
INTERESTED IN CONTROLLING THESE ISSUES.
FIRST OF ALL, YOU WANT TO BE A GOOD CITIZEN.
LIKE ALL OF YOU, I'M OUTRAGED. I'M ENFURIATED, AND OFFENDED BY
THE FRAUD WE SEE. AS WE'LL SEE, THIS IS NOT JUST A
FRAUD ISSUE. THERE IS A SPECTRUM OF
MECHANISMS BY WHICH WE CAN SAVE MONEY FROM THIS PROGRAM.
IN ADDITION, BEING IN THE HEALTH CARE BUSINESS, I THINK THAT JUST
THE WORD, HEALTH CARE, ASSOCIATED WITH PEOPLE WHO ARE
INVOLVED IN FRAUDULENT ACTIVITIES, CAST A LITTLE BIT
BIGGER SHADOW ON ALL OF US WHO ARE IN HEALTH CARE INDUSTRY AND
THAT VERY OFTEN PATIENTS OR PEOPLE WHO READ THE NEWSPAPER
DON'T -- DISASSOCIATE THE FRAUDULENT PEOPLE FROM PEOPLE
WHO ARE JUST TRYING TO DO THEIR JOB EVERY DAY.
I THINK IT UNDERMINES CONFIDENCE IN SOME AREAS AND PHYSICIANS
BEHAVIOR. IT MAKES PATIENTS QUESTION
SOMETIMES UNREASONABLY ACTIVITIES THAT PHYSICIANS
RECOMMEND FOR THEM THAT ARE GOING GOOD FOR THEM BUT THE
PATIENTS BECOME SUSPICIOUS OF TESTING AND SO ON.
I THINK OBVIOUSLY, IT'S GOING TO PROVIDE MORE RESOURCES FOR GOOD
HEALTH CARE IF WE ELIMINATE BAD HEALTH CARE.
AND IT'S SOMETHING THAT I BECAME AWARE OF AT A CONFERENCE IS HOW
MUCH THE DREAM THAT IS APPARENT FROM HEALTH CARE FRAUD IS TAKING
AWAY FROM OTHER LEGITIMATE PUBLICLY FUNDED PROGRAMS.
EDUCATION BEING ONE OF THEM. WE ARE CONSTANTLY FACED WITH THE
AWFUL FACT THAT THE EDUCATION SYSTEM IN THIS COUNTRY NEEDS A
LOT MORE. IF YOU SPEND IT ONE PLACE YOU
CAN'T SPEND IT IN ANOTHER. I THINK IT IS INCUMBENT UPON US
TO RETAIN CONTROL OF THE AREA IN WHICH WE WORK, WHICH IS HEALTH
CARE. BECAUSE IF WE DON'T TAKE AN
ACCOUNT ACTIVE ROLE IN TRYING TO CLEAN UP AREAS THAT WE COULD
CLEAN UP IN OUR OWN HOUSE, THEN SOMEBODY ELSE WILL DO IT FOR US.
AND THIS IS ANOTHER IMPORTANT REASON WHY PROVIDERS SHOULD BE
INVOLVED IN SUCH PROGRAMS. NOW, NEXT SLIDE.
THIS IS A QUOTE, WHICH I THINK REALLY DESCRIBES WHAT I THINK IS
VERY IMPORTANT. AND THAT IS THAT AMERICANS DO
TRUST THE PROFESSIONALS WHO TAKE CARE OF THEM.
UNIFORMLY, IN POLLS SUCH AS THIS, WHICH IS THE LATEST GALLUP
POLL FOR WHICH I COULD FIND A GRAPHIC, IDENTIFYING
PROFESSIONALS THAT AVERAGE INDIVIDUALS, BENEFICIARIES, IF
YOU WILL, LINKED TO PROFESSIONS. 3-4 TOP-RATED PRO PHYSICIANS IN
TERMS OF -- PROFESSIONS IN TERMS OF HONESTY AND ETHICS ARE HEALTH
CARE PROVIDERS. NURSES ALWAYS LEAD THE LIST.
FOR THE LAST 10 YEARS, NURSES LED FOR 9 OF THOSE YEARS.
THE ONLY YEAR THEY WERE DISPLACED WAS IN 2001 WHERE
AFTER 911, FIREMEN LED THE LIST. BUT THIS IS ROUTINELY LEADERS.
IT'S NOT FOR NO REASON AT ALL. PEOPLE DO RELATE TO THEIR HEALTH
CARE PROVIDERS AND MOST HEALTH CARE PROVIDERS ARE EARNING THAT
TRUST. BUT WITH THAT COMES THE
RESPONSIBILITY AND OBLIGATION TO BE INVOLVED IN AREAS WHERE YOU
CAN IMPROVE THE SYSTEM. YOU HAVE TO BE PROACTIVE.
AND SO, IN THIS SITUATION, IT'S NICE TO BE INCLUDED IN THAT
GROUP OF PROFESSIONALS WHO ARE LOOKED ON WELL BUT AT THE SAME
TIME, YOU NEED TO ASSUME THAT YOUR OBLIGATION AS A PHYSICIAN
OR ANY TYPE OF HEALTH CARE PROVIDER.
NOW, MY AREA OF INTEREST -- I WOULDN'T CALL IT
EXPERTISE -- NOT SO MUCH IN FRAUD BUT LOOKING TO A SYSTEM
WHERE OBVIOUSLY THERE IS ABUSE AND EVEN MORE IMPORTANTLY,
WASTE. IN EFFICIENCY IN THE SYSTEM.
AND I THINK THAT THERE IS SO MANY AREAS THAT WE COULD TOUCH
UPON WHERE, IF WE JUST IMPROVE THE EFFICIENCY OF PROVIDING
CARE, WE WOULD SAVE HUGE AMOUNTS OF MONEY.
THESE ARE NOT FRAUDULENT ACTIVITIES.
NOT MALICIOUS ACTIVITIES, BUT THEY ARE JUST ACTIVITIES WHICH
WASTE A LOT OF MONEY AND TIME AND I PERSONALLY HAVE A GREAT
INTEREST IN TRYING TO MINIMIZE THOSE.
NOW, WHAT DO I THINK CAN BE DONE?
WELL, AS I MENTIONED, IT'S NOT ALWAYS A MATTER OF FRAUD OR EVEN
ABUSE. IT'S SIMPLY SOMETIMES JUST A
MATTER OF WASTE. A LOT OF THIS WASTE HAS TO DO
WITH PEOPLE NOT BEING AWARE OF THES?
WHICH THEY WORK. WE NEED TO, AS WE ARE GOING TO
HEAR TODAY, INCREASE THE PROVIDER AND THE BENEFICIARY
AWARENESS. INFORMATION ACCESS AND EXCHANGE
TO ME, IS CRITICAL. AS A PHYSICIAN, I'M FRUSTRATED
IN MY OFFICE WHEN I CAN'T ACCESS INFORMATION FROM OTHER SOURCES.
IT'S A WASTE OF TIME AND PERSONNEL.
WHICH THEN LEADS TO REDUNDANCY THAT IS IT, IF YOU CAN'T GET IT,
VERY OFTEN YOU END UP REPEATING IT.
AND IT'S A VERY WASTEFUL SYSTEM. AND DESPITE THE AMAZING
TECHNOLOGY THAT WE HAVE, ELECTRONIC MEDICAL RECORDS OR
HIGHLY ADVANCED HOSPITAL SYSTEMS WHICH HAVE INFORMATION, THE
EXCHANGE IN INFORMATION ISN'T AS ALWAYS AS EASY AS WE LIKE TO BE
AND THEY THINK CAN BE IMPROVED. SEMINARS FOR SPECIALTY
SOCIETIES. I CAME ACROSS SOMETHING IN MY
OWN SPECIALTY SOCIETY WHICH IS A WEBINAR FOR FRAUD AND ABUSE.
THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS ARE
SPONSORING THIS WHERE ANYBODY WHO BELONGS ON TO THAT
ASSOCIATION CAN PAY ABOUT 100 DOLLARS AND GO OUT TO A
CONFERENCE WHICH WILL TELL US HOW TO IDENTIFY AREAS IN OUR
PRACTICE WHICH CAN BE IMPROVED. AND I THINK THAT MIGHT BE AN
AREA WHERE EVERY SPECIALTY WOULD BE HAPPY TO PARTICIPATE.
TO TAKE ADVANTAGES OF THE IDEAS WHICH ARE OFTEN REFERRED TO AS
BEST PRACTICES, MEANING IDENTIFYING IN AN ORGANIZED
CODIFIED WAY, PRACTICES TO APPROACH CERTAIN ILLNESSES AND
CERTAIN DIAGNOSTIC CATEGORIES IN A WAY IN WHICH WILL MAXIMIZE
EFFICIENCY. SO WHAT MR. MORRIS IS REFERRING
TO IS IMPORTANT. THERE ARE A LOT OF AREAS IN
MEDICINE THAT CAN BE IMPROVED AND I DON'T THINK THIS IS AN
EFFORT TO DEMONIZE PROVIDERS. I THINK PEOPLE SHOULD REALIZE
WHAT THE ULTIMATE OBJECTIVE IS TO REDUCE COSTS AND NOT TO
PUNISH PEOPLE BECAUSE THEY ARE IDENTIFYING SOMETHING WHICH MAY
BE WASTE. AND THEY ARE TRYING TO IMPROVE
IT. WE ARE ALL ON THE SAME TEAM IN
THAT REGARD. I THINK THERE IS LASTLY SOME
SYSTEMIC CHANGES THAT COULD BE APPLIED TO THE PRACTICE OF
MEDICINE AND NOT ALWAYS INITIATED BY PHYSICIANS OR
PROVIDERS. THEY HAVE TO COME FROM SOCIETY.
ONE EXAMPLE THAT COMES TO MIND THAT IS COMMONLY REFERRED TO,
AND I'M IN THE AREA NOT SO MUCH OF FRAUD BUT IN THE AREA OF
WASTE OR EFFICIENCY. IT'S HOW MUCH MONEY WE APPLY TO
END-OF-LIFE SITUATIONS. A HUGE AMOUNT OF MONEY
LEGITIMATELY GOES INTO THOSE SITUATIONS AND SOME OF THEM ARE
QUESTIONABLE BENEFITS. BUT OFTEN IT'S NOT A PHYSICIAN'S
ROLE TO DECIDE THAT. AND SOCIETY MUST BECOME INVOLVED
IN MAKE SOMETHING DECISIONS THAT WILL EVENTUALLY RESULT IN COST
EFFECTIVENESS. SO THESE ARE SOME OF THE
THOUGHTS THAT I HAVE WHICH I HOPE BEE GET TO EXPLORE AS THE
DAY GOES ON. JUST WANTED TO LEAVE YOU WITH A
LITTLE BIT OF MEDICAL PHILOSOPHY FROM MARK TWAIN.
HE SAID BE CAREFUL ABOUT READING HEALTH BOOKS, YOU MIGHT DIE OF A
MISPRINT. THANK YOU.
-- THANK YOU VERY MUCH, DR. WATSON.
[APPLAUSE] KATHY FROM THE FLORIDA HOSPITAL
ASSOCIATION. -- THANK YOU VERY MUCH.
I'M VICE PRESIDENT OF FINANCIAL SERVICES FOR THE FLORIDA
HOSPITAL ASSOCIATION AND AS A PART OF THAT ROLE WITH FINANCE,
I WANT TO REFER TO BACK TO THIS SLIDE FROM DR. WATSON AND SAY,
I'M NOT AN ACCOUNTANT. AT THE VERY BOTTOM 6 YOUR LIST
THERE, I WANTED TO BE CLEAR THAT'S NOT THE SIDE OF FINANCE I
DO. THE FLORIDA HOSPITAL ASSOCIATION
IS HONORED TO BE A PART OF THIS SUMMIT.
AND REPRESENTING A LARGE NUMBER OF THE HOSPITALS IN THE STATE,
WE REALLY DO APPRECIATE THIS OPPORTUNITY.
HOSPITALS HAVE HAD A LONGSTANDING COMMITMENT TO
PREVENTING FRAUD. WE STAND READY TO ASSIST HHS TO
GO AFTER AND PREVENT REAL FRAUD, THE FRAUD THAT WAS REFERRED TO
THIS MORNING AS BLATANT FRAUD. TELL US HOW WE CAN HELP.
WE ARE HERE AND READY TO DO WHAT WE CAN.
WE WANT TO BE PARTNERS IN THE SHARED GOAL OF STOPPING FRAUD.
WE ARE FACED WITH REDUCTIONS IN PROGRAMS SUCH AS MEDICAID
BECAUSE OF OUTSIDE FRAUDULENT ACTIVITIES.
THIS ROBS THE PROGRAM OF DOLLARS THAT COULD BE USED FOR EXPANDED
SERVICES AND PAYMENTS FOR LEGITIMATE SERVICES.
MEDICARE SPENDING FOR BENEFICIARIES, WHEN REPORTED FOR
ALL MEDICARE EXPENDITURES CASTS A NEGATIVE VIEW ON FLORIDA
HEALTH CARE PROVIDERS. IF YOU NARROW IN ON THE DETAILS,
YOU CAN SEE IT'S NOT ALL SERVICE LINES THAT ARE DISTORTED.
IT'S THE SAME BROADBRUSH. WE ARE DIFFERENT.
THERE ARE DIFFERENT TYPES OF PROVIDERS AND YOU HAVE TO LOOK
AT YOUR LEGITIMATE PROVIDERS VERSES THOSE THAT ARE NOT TRUE
HEALTH CARE PROVIDERS BUT ARE BILLING THE PROGRAMS.
HOSPITALS LIVE WITH THE COMPLEXITY AND DETAIL OF THE
MEDICARE AND MEDICAID ISSUES. RIGHT CARE AND QUALITY CARE IN
THE RIGHT PLACES AND AT THE RIGHT TIME.
WE STRIVE TO BILL CORRECTLY. I HAVE TO SAY WE ARE COMMITTED
TO COMPLIANCE. IN FLORIDA, WE HAVE A COUPLE OF
THINGS I WANT TO SHARE WITH YOU FROM A COMPLIANCE PERSPECTIVE.
WE HAVE A VERY ACTIVE GROUP OF HOSPITAL COMPLIANCE
PROFESSIONALS THAT COME TOGETHER ON A VERY REGULAR BASIS TO
REVIEW REGULATIONS, TO ADDRESS HOW THEY CAN BE COMPLIANT, TO
ENGAGE DIALOGUE WITH THE OFFICE OF CIVIL RIGHTS, WITH OUR
MEDICARE CONTRACTOR, WITH OTHER REPRESENTATIVES OF OTHER
AGENCIES WHOSE REGULATIONS WE ARE EXPECTED TO FOLLOW TO MAKE
SURE WE ARE UNDERSTANDING THEM CORRECTLY AND THAT WE ARE
IMPLEMENTING THE RIGHT POLICIES AND PROCEDURES.
IN ADDITION, WE HAVE DEVELOPED A PIER EFFECTIVENESS PROGRAM WHICH
HOSPITAL COMPLIANCE PROFESSIONALS REVIEW THE
PROGRAMS OF THEIR PEERS, LOOKING AT BOARD RELATIONSHIPS, AUDIT
ACTIVITY, EMPLOYEE RECOGNITION OF THE HOSPITALS COMPLIANCE
PROGRAM, THE ADMINISTRATION'S COMMITMENT TO COMPLIANCE AND
OTHER SUCH AREAS THAT ARE IMPORTANT, I THINK, AS
MR. MORRIS ADDRESSED, HAVING AN EFFECTIVE COMPLIANCE PROGRAM.
THIS PROGRAM HAS PROVEN INSIGHTFUL FOR BOTH OF THOSE
DOING THE ODDITS AND REVIEWS AS WELL AS THOSE BEING REVIEWED.
WE ARE LEARNING FROM EACH OTHER AND IT IS IMPORTANT TO GO OUT
AND LOOK AT WHAT ARE YOU DOING? WHAT ARE YOU DOING RIGHT?
THE HOW CAN YOU DO IT DIFFERENTLY OR HOW CAN YOU DO IT
BETTER? THERE ARE EXAMPLES OF HOW WE CAN
BETTER WORK TOGETHER TO ENSURE COMPLIANCE AND MAKE SURE THAT WE
ARE ALL UNDERSTANDING WHAT WE ARE SUPPOSED TO DO.
AND UNDERSTANDING IT CORRECTLY. FLORIDA WAS ONE OF THOSE STATES
THAT WAS LUCKY ENOUGH TO BE IN THE DEMONSTRATION FOR THE
MEDICARE RECOVERY PROGRAM, A PROGRAM NOW BEING EXPANDED TO
OTHER AREAS WITHIN THE MEDICARE PROGRAM NOT JUST MEDICARE PART A
AND PART B, BUT ALSO TO C AND D. BUT IT'S ALSO BEING EXPANDED TO
MEDICAID. THE RECOVERY AUDIT CONTRACTORS
WERE VERY QUICK TO IDENTIFY MISTAKES IN BILLING.
MANY OF THESE MISTAKES IN BILLING WERE IDENTIFIED FLEW
AUTO MADED EDITS. THIS PROGRAM BEGAN IN 2005.
MANY OF THE ISSUES THAT WERE IDENTIFIED DURING THE RECOVERY
AUDIT CONTRACTOR DEMONSTRATION HAVE YET TO HAVE EDITS
IMPLEMENTED AT THE CONTRACTOR LEVEL.
IF THE RECOVERY AUDIT --
THEY SHOULD BE PUT IN PLACE QUICKER.
THEY SHOULD BE PUT IN PLACE ON THE FRONT END AND THE CLAIMS
SHOULD BE PAID CORRECTLY THE FIRST TIME, NOT WITH A
SUBSEQUENT LEVEL OF REVIEW. FROM THE MEDICAID SIDE,
HOSPITALS IN FLORIDA HAVE BEEN UNDERGOING REVIEWS UNDER THE
MEDICAID INTEGRITY PROGRAM. WE RECEIVED RECORDS REQUESTS
OVER 21 MONTHS AGO. TO DATE WE HAVE NOT RECEIVED
FINAL AUDIT RESULTS OR FINDINGS. SUCH A DALLY DOES NOTHING TO
ASSIST US IN IDENTIFYING ERRORS IN NEED OF OUR PROMPT ATTENTION.
WE NEED TO HAVE THE INFORMATION PROVIDED TO US TO MAKE SURE THAT
WE ARE ABLE TO DO WHAT IS APPROPRIATE AND CORRECT.
IF WE ARE MAKING MISTAKES, WE NEED TO KNOW.
FINALLY, WITH THE CONTINUED COMPLIANCE FOCUS ON HOSPITALS,
WE OFTEN IDENTIFY ISSUES AND QUESTIONS THAT NEED
CLARIFICATION FROM THE STATE, FROM THE CENTERS FOR MEDICARE
AND MEDICAID SERVICES, OR VARIOUS CONTRACTORS.
WE NEED PROMPT IMPLEMENTING REGULATIONS.
WE NEED THE CONFLICTING PROVISIONS IN THE MEDICARE
MANUALS RECONCILED. WE CAN'T CONTINUE TO DELAY THESE
ACTIVITIES AND I KNOW THAT WE WOULD BE WILLING TO WORK WITH
CMS ON THIS PROCESS OF CLARIFICATION AND
RECONCILIATION. THIS WOULD ALLOW MORE EFFORTS TO
BE FOCUSED ON REAL FRAUD, THE TOPIC FOR THE DAY.
WE NEED THE TIME, THE MONEY, THE VARIOUS RESOURCES FOCUSED ON THE
BLATANT FRAUD MENTIONED THIS MORNING.
THE FLORIDA HOSPITAL ASSOCIATION, AND I HOPE I'M NOT
INAPPROPRIATELY SPEAKING FOR THE AMERICAN HOSPITAL ASSOCIATION
WHO IS ALSO REPRESENTED HERE TODAY, IS COMMITTED TO THIS
PARTNERSHIP. TO THIS COLLABORATION, AND TO
PROTECT THE MEDICARE PROGRAM. THANK YOU.
[APPLAUSE] -- THANK YOU.
AND WELCOME TO OUR NEW ATTENDEES WHO ARE JUST ARRIVING.
I HOPE YOU DON'T MIND THAT WE CONTINUE THE PROGRAM WHILE
YOU'RE BEING SEATED. NEXT, THE EXECUTIVE DIRECTOR OF
THE NATIONAL HEALTH CARE ANTIFRAUD ASSOCIATION.
-- THANK YOU, PETER. I'M A WARRIOR BY TRAINING.
AND I NOTICED WARRIORS WEREN'T ON THAT LIST.
[APPLAUSE] BUT I'LL SEE WHAT YOU CAN DO.
NATIONAL HEALTH CARE ASSOCIATION WHICH FORMED 25 YEARS AGO,
BASICALLY TO BRING THE PRIVATE AND THE PUBLIC SIDES TOGETHER IN
THE FIGHT AGAINST HEALTH CARE FRAUD.
IT WAS OBVIOUS BACK IN THE 80's IF YOU'RE GOING TO BE
EFFECTIVE AGAINST HEALTH CARE FRAUD, YOU HAD TO HAVE BOTH
INVOLVEMENT OF THE PRIVATE SIDE AS WELL AS THE PUBLIC SIDE.
SO IN ANTICIPATION OF THIS PRESENTATION AND TALK, I WENT
OUT TO A NUMBER OF OUR MEDICAL DIRECTORS ON THE PRIVATE SIDE
AND SAID, I WANT TO TELL SOME THINGS TO PROVIDERS THAT YOU
THINK THEY SHOULD KNOW FROM AN ANTIFRAUD PERSPECTIVE.
WHAT IS IT THAT IT SHOULD BE? AND THEY GAVE ME A LIST OF A
NUMBER OF THINGS. SO I THOUGHT FROM A VERY
PRACTICAL STANDPOINT, I WOULD GO OVER SOME OF THOSE THINGS.
FIRST OF ALL, PROTECT YOUR INFORMATION.
A LOT OF THE SCAMS OUT THERE ARE BASED ON THE USE OF PROVIDER
INFORMATION THAT HAS BEEN STOLEN OR TAKEN FROM A PROVIDER.
THERE IS A LOT OF TIMES WHEN CLAIMS ARE BEING PRESENTED THAT
ARE FRAUDULENT THAT BASICALLY HAVE PROVIDER INFORMATION THAT
HAVE BEEN TAKEN FROM ANOTHER PROVIDER.
SO BE CAREFUL WITH THAT. YOUR MPI, DEA NUMBERS, TIN
NUMBERS, YOUR BUSINESS INFORMATION.
TRY TO KEEP THAT AS CONFIDENTIAL AS YOU CAN AND BE VERY CAREFUL
IF YOU GET A REQUEST FOR THAT INFORMATION TO MAKE SURE YOU
DON'T RELEASE IT UNLESS YOU KNOW PRECISELY WHO THAT REQUEST IS
COMING FROM AND IT SHOULD BE RELEASED TO THAT PERSON.
THERE HAVE BEEN A NUMBER OF SCAMS WITH THAT INFORMATION HAS
BEEN STOLEN. THE OTHER SIDE OF THAT IS THAT
AS A HEALTH CARE PROVIDER, YOU ALSO HAVE ACCESS AND HAVE IN
YOUR POSSESSION, THE PRIVATE INFORMATION OF YOUR PATIENTS.
THEIR MEDICARE NUMBERS, THEIR PRIVATE INSURANCE NUMBERS, THOSE
TYPES OF THINGS. BE VERY CAREFUL WITH THAT
INFORMATION AS WELL AND BE CAREFUL WITH THE STAFF MEMBERS.
THERE HAVE BEEN A NUMBER OF CASE WHERE IS THAT INFORMATION HAS
BEEN STOLEN AND THEN SOLD ON THE OUTSIDE.
AND THAT'S SOMETHING THAT YOU REALLY HAVE TO HAVE POLICIES IN
PLACE AND PROCEDURES IN PLACE TO MAKE SURE THAT YOU DON'T HAVE
ANYONE THAT IS WORKING FOR YOU THAT GETS THAT INFORMATION OUT
ON THE OUTSIDE BECAUSE THAT INFORMATION IS USED TO FILE
FALSE CLAIMS. ANOTHER BIG AREA IS TRAINING.
YOU SHOULD TRY TO ENSURE THAT YOUR STAFF IS TRAINED.
FIRST OF ALL IN THE CODING AREA, YOU SHOULD HAVE A STAFF THAT IS
PROFESSIONALLY TRAINED IN CODING.
FOR EXAMPLE, THE AMERICAN ASSOCIATION OF PROFESSIONAL
CODERS HAS PROGRAMS. AND HAVE YOU HAVE THOSE CODERS
TRAINED SO THEY KNOW THE PROPER PROCEDURES AND CODES.
THE OTHER THING YOU SHOULD THINK ABOUT IS HAVING YOUR STAFF
TRAINED WITH RESPECT TO HEALTH CARE FRAUD AND ABUSE.
SIMPLE AWARENESS TRAINING. THAT TYPE OF TRAINING DR. WISE
MAN MENTIONED THAT HIS PROFESSIONAL SOCIETY HAS THAT
TRAINING. BUT IT'S AVAILABLE TO A NUMBER
OF SOURCES AT MY ORGANIZATION AND OTHER ORGANIZATIONS AS WELL
HAS TRAINING AVAILABLE IN HEALTH CARE FRAUD AND ABUSE AWARENESS.
AND I THINK THAT'S AN IMPORTANT THING TO KEEP IN MIND AS YOU GO
ABOUT THINKING ABOUT THE STAFF THAT YOU HAVE.
ALSO, BILLING COMPANIES. IF YOU'RE USING A BILLING
COMPANY, MAKE SURE THAT YOU KEEP TRACK OF WHAT THAT COMPANY IS
DOING FOR YOU, THAT YOU'RE LOOKING AT AT THE PROCESSES AND
PROCEDURES THERE AND YOU DON'T JUST TURN EVERYTHING OVER TO A
BILLING COMPANY WITHOUT KEEPING SOME SORT OF CONTROL AND
AWARENESS AS TO WHAT IS HAPPENING THERE.
THE EXCLUSION LIST. IF YOU'RE GOING TO HIRE STAFF
MEMBERS, MAKE SURE YOU'RE LOOKING AT THAT LIST.
THE INSPECTOR GENERAL HAS A LIST OF INDIVIDUALS THAT HAVE BEEN
EXCLUDED FROM THE MEDICARE PROGRAM FROM FEDERAL PROGRAMS.
MAKE SURE YOU'RE AWARE OF THAT LIST AND ARE TAKING A LOOK AT
THAT. ANOTHER THING TO BE AWARE OF, BE
VERY CAUTIOUS IF ANYONE WANTS TO COME TO YOU EVEN WITH A
PRESENTATION OR A PROPOSAL. IT'S SOMETHING THAT WILL
MAXIMIZE REIMBURSEMENT. WE HEAR THE TERM, THIS WILL HELP
YOU MAXIMIZE YOUR REIMBURSEMENT. THAT MAY BE ALL WELL AND GOOD
BUT BE VERY CAUTIOUS THERE. MAKE SURE THAT WHOEVER IS
PROVIDING YOU THAT INFORMATION IN A PRESENTATION FORM OR
TALKING ABOUT ANCILLARY-TYPE SERVICES, YOU MAY BE ABLE TO
HAVE IN YOUR OFFICE OR FACILITY, MAKE SURE YOU TAKE A VERY CLOSE
LOOK AT WHAT THAT IS ABOUT. RECENTLY, SOME INFORMATION
SHARING THAT WE DO BETWEEN THE PUBLIC AND PRIVATE SIDES, THERE
WAS A WEBSITE THAT WAS TALKING ABOUT SOME TESTING SERVICES THAT
COULD BE PROVIDED IN HOUSE THAT COULD LEAD TO, UP TO $100,000 IN
ADDITIONAL REIMBURSEMENT IN ANY GIVEN YEAR.
WHEN YOU HEAR CLAIMS LIKE THAT AND YOU HEAR A PITCH LIKE THAT,
BE CAUTIOUS ABOUT THAT. AND MAKE SURE THAT YOU TAKE A
HARD LOOK AT IT AND IF YOU HAVE A LEGAL COUNSEL, MAYBE HAVE
LEGAL COUNSEL TAKE A LOOK AT THAT BEFORE YOU GO DOWN THAT
ROAD. MORRIS ALREADY MENTIONED
COMPLIANCE PROGRAMS. THEY WILL BE MANDATORY.
THEY ARE ALREADY MANDATORY FOR SOME TYPES OF PROVIDERS BUT THEY
WILL BE MANDATORY FOR ALL PROVIDERS AND CERTAINLY TRAINING
IS THE PART OF THOSE COMPLIANCE PROGRAMS.
AND LASTLY, SECONDE -- SECRETARY SEBELIUS TALKED ABOUT THE 48
MILLION MEDICARE BENEFICIARIES AS BEING BOOTS ON THE GROUND
THAT COULD BE VERY USEFUL AND PROVIDE LEADERSHIP AND
INFORMATION WITH RESPECT TO THE FIGHT AGAINST HEALTH CARE FRAUD.
OBVIOUSLY, AS A PROVIDER, YOU'RE AN IDEAL POSITION TO DO THAT AS
WELL. NOT ONLY IN COMPLIANCE WITH
RESPECT TO YOUR PRACTICE WHAT YOU DO, BUT YOU WHAT SEE OTHERS
DOING. IF YOU'RE IN A POSITION WHERE
YOU BELIEVE THERE ARE PROVIDERS DOING SOMETHING THAT IS CLEARLY
FRAUDULENT, I THINK YOU HAVE AN OBLIGATION TO MAKE THAT KNOWN
SOME PLACE. IT DOESN'T MEAN YOU HAVE TO
BECOME AN INFORMANT BUT YOU CAN DO THAT ANONYMOUSLY.
BE OUT THERE AND IF YOU SEE SOMETHING THAT IS REALLY
EGREGIOUS, REPORT IT TO SOMEONE. DON'T JUST LET IT GO.
BECAUSE JUST AS THE BENEFICIARIES ARE IMPORTANT,
YOU'RE IMPORTANT AS WELL. THOSE ARE SOME THINGS AS A
PRACTICAL STANDPOINT YOU MAY WANT TO TAKE A LOOK AT AND THINK
ABOUT AS HEALTH CARE PROVIDERS. THANK YOU.
-- THANK YOU VERY MUCH. [APPLAUSE]
SECRETARY SEBELIUS MEANED I HAVE BEEN GIVEN THE PRIVILEGE OF
TAKING OVER A NEW OFFICE THAT WAS IN THE CENTERS FOR MEDICARE
AND MEDICAID SERVICES AND TAKE ON THE RESPONSIBILITY FOR
EXPANDING AND ENHANCING OUR EFFORTS TO FIGHT FRAUD AND WASTE
AND ABUSE AND CORRECT ERRORS IN THE MEDICARE AND MEDICAID
PROGRAMS. AND I WANT TO JUST TAKE A FEW
MINUTES TO SHOW YOU SOME EXAMPLES OF SOME OF THE NEW
VENTURES THAT WERE UNDERTAKING. THESE ARE THINGS THAT STARTED IN
THE MIAMI AREA. WE HAVE A VERY GOOD AND STRONG
TEAM DOWN HERE IN THE MIAMI AREA.
AND THESE ARE ACTIVITIES THAT STARTED DOWN HERE.
AND WE ARE VERY IMPRESSED WITH WHERE THEY ARE LEADING.
I WANTED TO GIVE YOU A LITTLE MORE DETAIL ON SOME OF THE
THINGS THAT SECRETARY SEBELIUS MENTIONED SO YOU'LL UNDERSTAND
THAT WHEN YOU DO THE THINGS THAT THE PANELISTS HAVE BEEN TELLING
YOU TO DO, THERE ARE RESULTS. THINGS HAPPEN.
AND WE CAN OR YOU CAN HELP US HAVE AN AFFECT ON THIS.
WE'LL SEE IF MY SLIDES WORK. SO MIAMI, UNFORTUNATELY -- BY
THE WAY, I GREW UP IN THE SOUTHERN DISTRICT OF FLORIDA
ALSO. SO I'M ALSO SENSITIVE ABOUT
THIS, ABOUT THIS BEING GROUND-ZERO FOR FRAUD.
AND I SHARE SECRETARY SEBELIUS'S INTEREST IN SEEING THAT IT
BECOMES GROUND-ZERO FOR FIGURING OUT WAYS TO COMBAT THESE SERIOUS
PROBLEMS. THERE IS A COUPLE OF AREAS THAT
HAVE BEEN MAJOR VULNERABILITIES DOWN HERE AS WELL AS ELSEWHERE
AROUND THE COUNTRY AND I'M GOING TO TALK TO YOU ABOUT THOSE VERY,
VERY BRIEFLY. AND THEN, GIVE YOU SOME IDEAS
ABOUT WHAT WE WANT TO DO IN TERMS OF EXPANDING THOSE MODELS
NATIONALLY. SO, WE HAVE DEVELOPED A SPECIAL
HOTLINE. THERE ARE HOT LINES -- THERE ARE
OTHER HOT LINES. THE OFFICE OF INSPECTOR GENERAL
OPERATES THE FRAUD HOTLINE THAT IS VERY USEFUL AND VERY
IMPORTANT AND HAS BEEN AROUND FOR A WHILE.
YOU'RE ALSO ABLE TO CALL 1-800-MEDICARE IF YOU HAVE ANY
PROBLEMS AND BEGIN A CONVERSATION THAT CAN LEAD TO A
REFERRAL IF YOU THINK THERE IS A PROBLEM.
BUT IN SOUTH FLORIDA, WE HAVE ESTABLISHED A SPECIAL HOTLINE
THAT IS DESIGNED TO ADDRESS AND TO TEACH US HOW TO USE THESE HOT
LINES BETTER IN TERMS OF BOTH TAKING IN THE INFORMATION FROM
BENEFICIARIES AND OTHERS AND ALSO GIVING YOU BACK FEEDBACK
AND DEMONSTRATING WHAT THE AFFECTS HAVE BEEN OF THE SO, WE
ARE PRINTING THE NUMBER, THE HOTLINE NUMBER, ON ALL OF THE
SUMMARY NOTICE THAT IS THE MEDICARE BENEFICIARIES GET.
THE REST OF THE COUNTRY, PEOPLE GET SUMMARY NOTICES EVERY THREE
MONTHS. HERE WE ARE SENDING THEM OUT
EVERY MONTH. AND YOU CAN SEE THAT JUST SINCE
THE HOTLINE STARTED, THERE HAVE BEEN A VARIETY OF DIFFERENT
KINDS OF RESULTS THAT HAVE ACTUALLY TAKEN PLACE IN TERMS OF
WATCHING VERY CAREFULLY THE BILLS THAT ARE SUBMITTED BY
CERTAIN PROVIDERS WHO ARE IDENTIFIED THIS WAY IN TERMS OF
REVOKING A CERTAIN NUMBER. AND YOU CAN SEE THAT EVEN A
SMALL NUMBER ADDS UP TO A VERY LARGE AMOUNT OF FINANCIAL
INVOLVEMENT AS FAR AS THE LEVEL OF FRAUD.
ALMOST 3 MILLION DOLLARS USED BY LAW ENFORCEMENT.
TWO MILLION DOLLARS DENIED BY REVIEWING CLAIMS BEFORE THEY
WERE PAID AND 11 MILLION THAT WAS REFERRED FOR COLLECTIONS.
SO, AS I SAID, OUR HOTLINE IS IN THIS AREA ON THE SUMMARY NOTICES
AND I WANTED TO MAKE SURE THAT EVERYBODY HAD IT AVAILABLE SO
YOU KNEW WHERE TO CALL. AND YESTERDAY, AS WE WERE
TOURING THE CALL CENTER DOWN HERE, I DID WARN THE CALL CENTER
OPERATORS THAT THEY SHOULD EXPECT RATHER BUSY WEEK
UPCOMING. THE SECRETARY AND THE ATTORNEY
GENERAL BOTH MENTIONS THE NEW FOCUS ON TRYING TO PREVENT
PROBLEMS IN THE FIRST PLACE. THE PROSECUTIONS THAT RESULT IN
OUR LAW ENFORCEMENT COLLEAGUES INVESTIGATE PEOPLE WHO ACTUALLY
HAVE GOTTEN AWAY WITH SOMETHING ARE VERY IMPORTANT AND WERE
CLOSE PARTNERS IN PURSUING THE LAW ENFORCEMENT APPROACH.
BUT THAT MISS THE POINT AS THE U.S. ATTORNEY MENTIONED OF
INTERVENING TO PREVENT THESE PROBLEMS IN THE FIRST PLACE.
LETTING DOCTORS AND HOSPITALS THAT BELONG IN THE MEDICARE AND
MEDICAID PROGRAMS IN AS PAINLESSLY AS POSSIBLE AND
KEEPING OUT THE ONES WHO ARE FRAUDULENT AND DON'T BELONG IN
THE PROGRAM. THAT'S OUR SYSTEM FOR ENROLLING
AND SCREENING PROVIDERS AND MAKING SURE THAT THE GOOD ONES
GET IN AND THE ONES WHO DON'T BELONG THERE DON'T GET IN IN THE
FIRST PLACE. WE HAD A SPECIFIC PROJECT HERE
IN SOUTH FLORIDA THAT FOCUSED ON DOING IN.
AND WE HAVE BEEN GOING OUT AND CHECKING, MAKING SITE VISITS AND
VISITING TO SEE WHETHER PEOPLE WHO WANTED TO BE OR WHO WERE
ABLE TO BILL MEDICARE, ACTUALLY PROVIDING SERVICES.
AND AS YOU CAN SEE, ABOUT A THIRD OF THE VISITS -- THIS IS
WHAT THE SECRETARY ELUDED TO -- JUST SINCE IT STARTED VERY
RECENTLY, ABOUT A THIRD HAVE LED TO REVOCATIONS OF THEIR ABILITY
TO BILL MEDICARE. AND THAT IS LEADING TO MAJOR,
MAJOR SAVINGS ALREADY. ANOTHER WAY IS TO WATCH VERY
CLOSELY WHEN FRAUD PERPETRATORS SHIFT FROM ONE KIND OF SCAM TO
ANOTHER KIND OF SCAM TO ANOTHER KIND OF SAME SCAM.
WE ARE DOING A PROGRAM DOWN HERE TO CONTROL THE LEVEL OF ENTRY TO
GIVE US TIME TO SCRUTINIZEDINIZE PEOPLE WHO WANT TO ENTER INTO
PROVIDER RELATIONSHIPS WITH MEDICARE AND MEDICAID AND HAVE
THE TIME TO MAKE SURE THAT WE LOOK AT THEM VERY CAREFULLY AND
LOOK AT THE NEED FOR WHAT THEY ARE DOING.
AND ALSO LOOKING AT SERVICES THAT ARE BEING BUILD FOR VERY
CAREFULLY AND -- BILLED FOR VERY CAREFULLY AND WORKING VERY
CLOSELY WITH THE HEALTH CARE PROVIDERS ON DEFINING WHICH
PATIENTS NEED HOME HEALTH SERVICES OF VARIOUS KINDS AND
WHICH ONES DON'T. THIS IS ALL PART OF THE
INITIATIVE THE PRESIDENT AND THE SECRETARY AND ATTORNEY GENERAL
HAVE BEEN FIRMLY COMMITTED TO. IT'S PART OF THE COMMITMENT THAT
THE CONGRESS MADE BY STRENGTHENING A VARIETY OF LAWS
WE HAVE AT OUR DISPOSAL AND BY PUTTING RESOURCES INTO THIS.
WE ARE ONE OF THE PARTS OF GOVERNMENT THAT -- IN A WAY IT'S
UNFORTUNATE BUT THE MORE WE SPEND ON FRAUD, THE MORE WE
RECOVER IN THE GOVERNMENT. THAT'S UNFORTUNATE BECAUSE THAT
MEANS THERE IS A LOT OF MONEY TO RECOVER OUT THERE BUT IT'S ALSO
GOOD IN THE SENSE THAT IT'S A GOOD RETURN ON THE INVESTMENT OF
THE PUBLIC DOLLAR AND DRESS ENTRUST US WITH RESOURCES TO DO
THIS. I THANK YOU FOR YOUR
PARTICIPATION TODAY. AND WE ARE NOW READY IF WE HAVE
A LITTLE BIT OF TIME FOR -- I'M GETTING A -- NO TIME FOR
QUESTIONS AND ANSWERS. THAT LEADS ME TO REMIND EVERYONE
THAT WE DO HAVE THE WORKSHOPS THIS AFTERNOON.
THAT WILL BE MUCH MORE INTERACTIVE AND GIVE EVERYBODY A
CHANCE TO RAISE QUESTIONS AND INTERACT WITH A NUMBER OF US IN
THE SMALLER GROUPS. THERE WILL BE A WORKSHOP FOR
PROVIDERS AND THEN THERE WILL BE WORKSHOP FOR BENEFICIARIES, ONE
IN ENGLISH AND ONE IN SPANISH AS WELL.
SO THANK YOU ALL VERY MUCH FOR ATTENDING THIS MORNING AND WE
ARE READY TO MOVE INTO OUR NEXT PANEL.
THANK YOU. [APPLAUSE]