SEATTLE, WA/EDMONDS, WA (December 1, 2009) – OCS HomeCare, a business unit for OCS (formerly Outcome Concept Systems, Inc.) is proud to announce a new partnership with the Home Care Association of Washington to offer Risk Profile Analysis to its home health agency members at exclusive discount rates. The timely Risk Profile Analysis publication helps prepare agencies for the imminent increase in audits from multiple regulatory compliance entities to identify Medicare overpayments, improper coding, and fraud and abuse patterns.
Risk Profile Analysis provides an overview of performance data on a variety of regulatory-related metrics, including 30 indicators that state and federal entities may use to evaluate suspect tendencies and potential recoupment value for member agencies. Agency data will be benchmarked against the homecare industry’s largest database by OCS HomeCare. The results provide easy-to-understand areas where data might look questionable to regulatory entities. What’s more, the Risk Profile Analysis can be leveraged to demonstrate compliance to internal and external stakeholders.
Brief Background
On May 20, 2009, President Barack Obama signed the Fraud Enforcement and Recovery Act (FERA) into law, introducing sweeping changes to the False Claims Act and providing hundreds of millions of dollars for enforcement. On the same date, Attorney General Eric H. Holder Jr. and Health and Human Services Secretary Kathleen Sebelius announced a new and aggressive interagency task force called the Health Care Fraud Prevention and Enforcement Action Team (HEAT) to combat Medicare and Medicaid fraud.
The Obama administration has repeatedly remarked that the current model of healthcare is unsustainable and that any healthcare reform plan must work to curb skyrocketing expenses for the Centers for Medicare and Medicaid Services (CMS). The administration’s goal is to cut $313 billion from CMS over the next 10 years [source]. Healthcare fraud enforcement is clearly a top priority of the Obama administration to recover a portion of this amount.
In the near future, several regulatory entities will begin to clamp down on the healthcare industry, especially home health agencies because of a 44% increase in Medicare spending over the last five years [GAO source; source]. As a result, providers should expect to come under increased scrutiny from several different regulatory bodies.
About Home Care Association of Washington (HCAW)
Formed in 1968, HCAW is a non-profit association dedicated to uniting licensed home health, hospice, and home care agencies in order to promote in-home care as a vital component of the health care delivery system. HCAW works to develop and foster high standards of care, advocating for the patients and clients HCAW members serve, increasing the visibility of home services, and educating, informing and assisting HCAW members and the general public.
About OCS HomeCare
OCS HomeCare empowers home health and hospice organizations with results-driven data intelligence, plus the largest and most accurate homecare database in the industry. Homecare providers, payers, associations, government agencies, vendors, and consultants all turn to OCS to elevate decision-making, raise the bar on results, and bring home positive outcomes. For more information about OCS HomeCare, please call 888.325.3396.