The Illinois’ home health care industry has been taking center stage of late, thanks in large part to an expose published by the Chicago Tribune that highlighted rampant fraud still hampering these services. Due to a number of factors, it became exceedingly easy for someone to start their own home care agency and with minimal oversight and loose regulations, fraud took on a life of its own.
It took the federal government stepping in and declaring that no new certifications for agencies would be permitted until such time that the state could manage its affairs properly. After all, the federal government, through CMS (Centers for Medicare and Medicaid Services) foots a significant portion of the bill for in home care.
Since that expose, people have written in to the Chicago Tribune with accounts of their own experiences in Illinois’ home care industry. One former visiting nurse recounted the frustrations she witnessed that seem to have defined some agencies for years now.
Published in the Chicago Tribune, an editorial entitled, Letter: I saw fraud in Illinois’ home health care industry firsthand, written by Barbara Dermody:
“During the visits to the agencies, I also made patient home visits with agency staff. It was so frustrating to see multiple patients who did not require home health services. Yes, they had a physician order for home care but their medical condition was stable and they were not homebound as required by Medicare. It was not unusual to see patients being recertified again and again for an additional 60 days of care even when they did not need it.”
Home care agencies across the country are subject to a great deal of scrutiny, often because most men and women have no direct, prior experience dealing with these services and have no idea what to expect. When stories of fraud, abuse, or other crimes or inappropriate behaviors are covered in major news outlets, it spreads a broad brush across the entire industry.
This can make it more difficult for small agencies to spread a positive message and in places like Illinois, the challenges can be even greater. The federal government has been cracking down on fraud for years, but with such a vast array of offenses and too much loose oversight, it has weighed down some who truly have a passion for helping people in need.
The positive stories about what home care offers is integral information people need to hear, especially in light of the continuing problems the minority of corrupted agencies create for the rest. These firsthand accounts can highlight the problems, but other accounts can also advertise the benefits, if agencies take the time to publicize them.
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