Wednesday, April 15, 2009

Home Health Fraud: Attorney Commentary On L.A. Times Article

There are exceptional overall savings to be found in home health care. In addition, home health care helps low-income people who are old and incapacitated stay out of nursing homes and board and cares and minimizes in-patient visits to the hospitals by providing ongoing care. The benefits of California's home health program do not get fully reported. Instead, the focus is on the small percentage of fraud in the program.

The Los Angeles Times reports that fraud is infecting California's In Home Supportive Services Program. California is set to spend more than $5 billion this year to provide home health care. This program is only available to those who are over 65 or disabled or blind (and disabled children). However, according to the Los Angeles Times, fraud has become a problem because there are limited funds available for oversight and investigation. The L.A. Times admits the program is a success but does not give any examples of the money saved or the lives extended or improved by the program.

The L.A. Times has a couple of fraud examples in the article. One man who claimed he was disabled and couldn’t get out of bed had his children bill the state $150,000 to care for him and his wife. Turns out he was spending eight to 10 hours a day working on an ice-cream truck.

For the article:

An efficient initial screening program (such as a questionnaire to be completed under penalty of perjury), fraud prevention program and ongoing random audit should be implemented as soon as possible since if the fraud is allowed to increase, the fraud will be used as a reason to dismantle a program that makes great economic and health sense.

Any questions or comments should be directed to: Tracy Green is a principal at Green and Associates in Los Angeles, CA. The firm focuses its practice on the representation of licensed professionals and businesses in civil, business, administrative and criminal proceedings, with a specialty in health care providers.


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