Fraud or abuse to report? Call your local attorney
It had to happen. The government vows to clean up fraud and abuse in Medicare, and our ever-vigilant legal profession is only too eager to help.
Lawyers in Jackson, MS, routinely appear in commercials on local television stations to exhort people, usually former patients or employees, to turn in hospitals, doctors, and home health agencies they suspect of committing fraud and abuse. Suddenly, Operation Restore Trust is looking like the House Unamerican Activities Committee.
Charles Homan, vice president of development at HealthCare Visions, a management services company based in Hollandale, MS, reports the trend, saying his organization holds seminars to educate physicians, hospitals, and home health agencies about fraud and abuse issues.
The commercials have been running for a few weeks. The spots actually mention ORT by name, Homan says. So far, there have been no reports of home health agencies in his area being charged with any fraudulent or abusive practices. t
Hospital-based agency wins antitrust lawsuit
By dismissing a lawsuit brought by a freestanding home care provider against a hospital-based agency, a U.S. District Court judge in Wilmington, DE, has given hospitals and their home care affiliates a significant victory, it would seem.
The case, which pitted Delaware Health Care, a home care and infusion therapy provider, against Medical Center of Delaware and its home infusion business, demonstrates that hospitals will not be automatically considered in violation of antitrust laws when they market their own home care services.
The lawsuit, filed in 1994, charged that the medical center used its strong presence to monopolize the area’s home care market. Delaware Health also charged that the medical center had denied its patients access to home care providers other than those it owned.
Judge Murray Schwartz ruled earlier this year that other referral sources existed for Delaware Health and that the medical center’s discharge process was not essential to its survival.
What this ruling’s impact will be nationwide remains to be seen, but it clearly has implications beyond Delaware.
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