Home Health & Hospice Week

One guilty-until-proven-innocent provision will shutter some blameless providers, expert says. Under the health care reform law's tough new fraud-fighting provisions, regulators will take your money first and ask questions later. "The [HHS] Secretary may suspend payments to a provider of services or supplier ... pending an investigation of a credible allegation of fraud against the provider of services or supplier, unless the Secretary determines there is good cause not to suspend such payments," says the Patient Protection and Affordable Care Act (PPACA). The Department of Health and Human Services will "consult with" the HHS Office of Inspector General to determine whether the allegation of fraud is credible and therefore triggers the suspension, continues the legislation that President Obama signed into law March 23. Timeline: The law contains no implementation date for this provision, but does direct HHS to publish regulations about the change. This provision finds the provider guilty without a [...]