Given a choice, most of us would probably choose to die at home, in the company of loved ones, rather than end our lives in a sterile, modern hospital or other institutional facility.
The federal crackdown on healthcare fraud, which is necessary and well-intentioned, has eliminated the option. Under new rules imposed by the Centers for Medicare and Medicaid Services, a nationwide six-month moratorium is now in place, blocking approval of any new home health or hospice care.
Recommended Stories
At first glance, that might seem reasonable. Months of investigation into brazen fraud among some sham care providers in Los Angeles County connected to organized crime rings has raised concerns that the system is subject to widespread abuse. The public’s interests must be protected, but any corrective action must be taken deliberately and carefully.
WANT TO WIN THE WAR ON FRAUD? PASS THE REPUBLICAN RECONCILIATION BILL
President Donald Trump ordered Health and Human Services Secretary Robert F. Kennedy Jr. to take decisive action in the new “war on fraud” he launched in his latest State of the Union address. CMS Administrator Mehmet Oz is now busy decertifying providers whose billing raised serious red flags and is pressuring states to strengthen oversight. This is warranted and should be applauded.
But blue California’s failure to police the actions of healthcare providers to whom it passes along federal funds should not be a reason to deny services to honest, needed patients provided by honest operators in red Texas. But this approach, without meaning to, is forcing millions of critically ill people into more expensive, hospital-based end-of-life care.
With the federal government in debt to the tune of $30 trillion, no one can deny the urgency of saving wherever possible. The broad-stroke approach to enforcement does that, but in a way that unfairly affects legitimate, hardworking providers and those in their care.
Bad actors are bilking taxpayers and harming trust among families. With better enforcement of existing policies, the administration could effectively focus on removing criminals from the system while strengthening people’s access to two of Medicare’s most important and popular benefits.
Millions of patients utilize home health and hospice services each year. One is the preferred pathway for seniors to receive skilled nursing care at home rather than in a hospital or nursing home, allowing them to be closer to loved ones in a familiar environment. The other is an important benefit established under President Ronald Reagan that allows Medicare beneficiaries with less than six months to live to receive palliative care and die with dignity.
These are vital options, important to society as well as healthcare. Federal bureaucrats are not bound by the Hippocratic oath. The national moratorium is doing harm because it doesn’t distinguish between fraudsters and high-quality, compliant providers. It treats them the same, and we’re better than that.
Fraud is most prevalent in large urban areas such as Los Angeles, New York, and Minneapolis. The national approach spreads the resources needed to combat fraud thinly, making the fight more difficult. Even worse, it creates a serious barrier to patient access in rural communities already experiencing shortages of home health and hospice providers.
Workforce challenges plague this sector of the economy. By preventing new providers from opening, needy patients will wait until they can no longer. As rural hospitals close and home care access declines, what will patients and their families do?
In the opinion of the American Hospital Association, “There are many rural and underserved areas of the country where hospitals struggle to find appropriate discharge locations for patients, and home health agencies and hospice providers are essential to ensuring timely and safe next levels of care. This moratorium may exacerbate these existing difficulties.”
DEMOCRATIC STATE ATTORNEYS GENERAL REBUFF JD VANCE’S INVITATION TO ANTI-FRAUD MEETING
The eradication of Medicare fraud is a virtuous objective. Trump, Kennedy, and Oz are right to make it a top priority. Moving forward, they should take a targeted approach, hunting where the ducks are rather than where they aren’t.
This will ensure patients’ access to home health and hospice care across all communities, rather than leaving them languishing in the hospital when they can’t find a home-based care provider, which doesn’t fight fraud but does drive up costs dramatically. In this effort, we want Washington to be both smart and compassionate.
Peter Roff is a veteran journalist and former columnist for UPI and U.S. News & World Report. He is also an international commentator affiliated with several Washington-based public policy groups. Email him at [email protected] Follow him @TheRoffDraft.
