National task force makes nursing homes first target

At a closed-door meeting last week, the National Health Care Fraud and Abuse Task Force convened for the first time, and the first item on its agenda was nursing home fraud. According to Chris Watney, a spokeswoman for the Department of Justice, quality of care issues at nursing homes will be a particular focus of the new task force, which is composed of top officials from federal, state and local law enforcement agencies. Federal agencies represented at the meeting included the Department of Justice, the Office of the Inspector General and FBI as well as the National Association of Attorneys General and the National District Attorneys Association.

The task force will focus on a full range of issues including procedures for the coordination of enforcement efforts that impact multiple jurisdictions and the use of information technology to detect and combat fraud, reports National Association of Attorneys General spokeswoman Maureen Thompson.

But coming on the heels of a range of administration anti-fraud efforts targeted at nursing homes, that industry can only wonder what lies around the next corner. "These are areas that have been the focus of heightened regulatory attention for some time," says Howard Sollins, JD, with the law firm Ober, Kaler in Baltimore. "One of the most important things facilities must realize is that regulatory agencies may seek to cooperate with each other but the basic route to demonstrating compliance is still through the HCFA survey process."

While other agencies are often looking at broader issues, Sollins adds, it’s still the survey and certification process that is the trigger for heightened scrutiny on quality of care issues. "The best thing facilities can do is have strong quality improvement process in place that identify and fix problems," advises Sollins. But Sollins also notes that facilities sometimes rush to allege compliance as early as possible because they are fearful of civil monetary penalties and other remedies such as a ban on payment for new admissions. "It is also important for facilities to put permanent measures in place and allege compliance when they know that the compliance can be maintained," adds Sollins.