The entire U.S. Department of Justice news release detailing this story is reprinted below . . .





Fraud offenders convicted in massive home healthcare case

September 21, 2011

Nearly 50 doctors, nurses and other providers working for a pair of Miami-Dade home healthcare agencies have been convicted for Medicare fraud.

BY JAY WEAVER

Federal prosecutors have steamrolled one Medicare-fraud offender after another in a sprawling Miami-Dade home healthcare racket, picking up 10 more guilty pleas this week.
The $25 million scheme — fueled by bribes and kickbacks — has implicated 54 doctors, nurses, operators and recruiters who worked for Florida Home Health Care Providers and ABC Home Health.
The shuttered agencies collected $15 million from the taxpayer-funded Medicare program by submitting false claims for purported diabetic and physical therapy services between 2006 and 2009.
Among the latest offenders to plead guilty: Ignacio Angulo, a licensed practical nurse and patient recruiter for Florida Home Health, and Eneida Fry, who worked as a registered nurse and recruiter for that agency and ABC Home Health, according to prosecutors.
Angulo and Fry, along with other agency nurses, falsified Medicare patients’ records by noting “non-existent symptoms” such as tremors, impaired vision, weak grips and an inability to walk to make it appear they qualified to be treated at home, according to Justice Department lawyer Joseph Beemsterboer.
The agencies’ billings included sending skilled nurses twice daily to diabetic patients’ homes to give them their insulin injections — patients who had the ability to inject themselves, he said. The patients also received kickbacks, such as cash, groceries and other gifts in exchange for allowing their valuable Medicare cards to be used to bill the government program.
On Monday, another nurse and a patient recruiter are expected to plead guilty for their roles at ABC Home Health , 8360 W. Flagler St., and Florida Home Health, 4150 NW Seventh St.
Since 2009, the Justice Department has convicted nearly all of the 54 defendants indicted for Medicare fraud in the ongoing conspiracy case, including Gladys Zambrana and her son, Javier Zambrana, who owned and operated the two home healthcare agencies.
The one exception: Miami-Dade physician Jorge Dieppa Jr., who was found not guilty earlier this year by a federal jury of conspiring to bilk the Medicare program and falsifying patient records in exchange for kickbacks.

Dieppa, who took the witness stand in his own defense, was accused of referring hundreds of patients to ABC Home Care and Florida Home Care.

But Dieppa testified that he evaluated all of his patients. The doctors also said he relied on teams of nurses before determining whether the Medicare patients were qualified to receive diabetic services at home.

Two other physicians, Jose Nunez, of Miami-Dade, and Fred Dweck, a retired Broward County surgeon, were not as lucky as Dieppa.
This year, they pleaded guilty to fraud charges, after admitting they wrote prescriptions for hundreds of homebound patients and received kickbacks as payments for their services.

One remaining doctor, Francisco Gonzalez, is expected to go to trial.
Read more: http://www.miamiherald.com/2011/09/22/2420498/fraud-offenders-convicted-in-massive.html#ixzz1YnytlPKC


From the U.S. Department of Justice, September 21, 2011:

Ten Miami-Area Residents Plead Guilty in $25 Million Health Care Fraud Scheme


September 21, 2011

WASHINGTON – Ten Miami-area residents pleaded guilty today and yesterday in U.S. District Court in Miami for their participation in a $25 million home health Medicare fraud scheme, announced the Department of Justice, the Department of Health and Human Services (HHS) and the FBI.
Each defendant pleaded guilty before U.S. District Judge Joan A. Lenard to one count of conspiracy to commit health care fraud. According to plea documents, the defendants included an administrator, nurses and patient recruiters for two related Miami home health care agencies, ABC Home Health Inc. and Florida Home Health Providers Inc. ABC and Florida Home Health purported to provide home health and therapy services to Medicare beneficiaries. However, according to court documents, the agencies only existed to defraud Medicare.
The 10 defendants each admitted that they participated in a fraud scheme to bill the Medicare Program for expensive physical therapy and home health care services that were prescribed by doctors but were medically unnecessary and never provided.
According to court documents, beginning in approximately January 2006, and continuing until approximately March 2009:

• Licet Diaz, 49, worked at ABC and Florida Home Health as an administrator. As a result of Diaz’s participation in the illegal scheme, Medicare was billed approximately $7.8 million.
• Fidel Castro, 48, worked at ABC as a patient recruiter. As a result of Castro’s participation in the illegal scheme, Medicare was billed approximately $550,000.
• Jose Ros, 71, worked for both ABC and Florida Home Health as a patient recruiter. As a result of Ros’ participation in the illegal scheme, Medicare was billed approximately $395,000.
• Eneida Fry, 46, worked for ABC and Florida Home Health as a registered nurse and a patient recruiter. As a result of Fry’s participation in the illegal scheme, Medicare was billed approximately $395,000.
• Oscar Martinez, 54, worked for Florida Home Health as a patient recruiter. As a result of Martinez’s participation in the illegal scheme, Medicare was billed approximately $390,000.
• Juana Rivas, 46, worked at Florida Home Health as a patient recruiter. As a result of Rivas’ participation in the illegal scheme, Medicare was billed approximately $250,000.
• Lesder Casanova, 40, worked at ABC as a patient recruiter. As a result of Casanova’s participation in the illegal scheme, Medicare was billed approximately $195,000.
• Ignacio Angulo, 48, worked at Florida Home Health as a licensed practical nurse and a patient recruiter. As a result of Angulo’s participation in the illegal scheme, Medicare was billed approximately $190,000.
• Raul Alvarez, 48, worked at Florida Home Health as a patient recruiter. As a result of Alvarez’s participation in the illegal scheme, Medicare was billed approximately $118,000.
• Barbara Gonzalez, 38, worked at ABC as a patient recruiter. As a result of Gonzalez’s participation in the illegal scheme, Medicare was billed approximately $40,000.

According to court documents, Fry and Angulo, along with their co-defendant nurses, falsified patient files for Medicare beneficiaries to make it appear that the beneficiaries qualified for home health care and therapy services. Fry and Angulo admitted that they knew the beneficiaries did not qualify for and did not receive the services. Fry, Angulo, and their co-defendant nurses described in nursing notes and patient files non-existent symptoms such as tremors, impaired vision, weak grip and inability to walk without assistance. Defendants included these symptoms to make it appear that the patients were unable to self-inject insulin and were homebound, thus appearing to qualify for home health care benefits under Medicare. The files were falsified so that Medicare could be billed for medically unnecessary therapy and home health related services.

According to plea documents, Diaz distributed kickback payments to the patient recruiters on behalf of the owners of ABC and Florida Home Health. Diaz worked in the offices of ABC and Florida Home Health and was aware that office staff manipulated the patient files and nursing notes for patients at ABC and Florida Home Health. Specifically, Diaz was aware that office staff manipulated the nursing notes by adding patient conditions, such as shortness of breath, hand tremors and poor vision, which were non-existent. The patient files and nursing notes were fabricated to make it appear that the patients qualified for the services.

Nine of the defendants admitted to recruiting Medicare beneficiaries who would allow ABC and Florida Home Health to bill Medicare for home health care and therapy services that were medically unnecessary and/or never provided. In doing so, the defendants solicited and received kickbacks and bribes from the owners and operators of the home health agencies in return for allowing the companies to bill the Medicare program on behalf of the recruited patients. The defendants knew that the patients they recruited did not qualify for the services billed to Medicare. In addition, the defendants knew that the patient files for their recruited patients were falsified in order to make it appear that the patients qualified for the services.

The defendants were originally charged in a February 2011 indictment. Five other co-conspirators have pleaded guilty for their roles in the fraud scheme: Jose Nunez, M.D., Lisandra Alonso, Luisa Morciego, Vicente Guerra and Farah Maria Perez.

Sentencings have been scheduled for various dates in October, November and December 2011.

The charge of conspiracy to commit health care fraud carries a maximum prison sentence of 10 years. The defendants also face fines and terms of supervised release, as well as forfeiture of any property or proceeds derived from their criminal activities.

The pleas were announced by Assistant Attorney General Lanny A. Breuer of the Criminal Division; U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida; John V. Gillies, Special Agent-in-Charge of the FBI’s Miami field office; and Special Agent-in-Charge Christopher Dennis of the HHS-Office of Inspector General (HHS-OIG), Office of Investigations Miami office.

This case is being prosecuted by Trial Attorney Joseph S. Beemsterboer and Acting Assistant Chief Benjamin D. Singer of the Criminal Division’s Fraud Section. The case was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Miami.

Since their inception in March 2007, Strike Force operations in nine locations have charged more than 1,140 individuals who collectively have falsely billed the Medicare program for more than $2.9 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to: http://www.stopmedicarefraud.gov/ .


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Disabled-aid agency's new chief questions whether funding can sustain its mission

By Christine Jordan Sexton, 9/21/2011
www.TheFloridaCurrent.com

The Agency for Persons with Disabilities usually is under the microscope for financial reasons. Significant financial deficits and long waiting lists for waiver services have plagued APD since its inception and, in two presentations before the Legislature this week, newly hired APD Director Mike Hansen told legislators why.

The money the agency is given, he said, isn't enough to fulfill its mandate from the Legislature to provide community-based services to developmentally disabled people so they can live in communities and not in institutions.

"I think we may have a discrepancy, or difference of approach, between what the law says and the amount of money that's available to fund the things (required services) in the law," said Hansen, who was named APD director by Gov. Rick Scott on July 28.

Hansen suggested to both the House Health & Human Services Access Subcommittee and the House Health Care Appropriations Subcommittee that legislators may want to "look at the requirements and the funding, and reconcile the issues."

Specifically, Hansen noted the law directs the state to give the "greatest priority" to develop community-based programs and services that "enable individuals with developmental disabilities to achieve their greatest potential for independent and productive living, enable them to live in their own homes or in residences located in their own communities, and permit them to be diverted or removed from unnecessary institutional placements."

Hansen said the language was "broad" given the current funding the agency receives.

Since 2004 the agency has been charged with providing services to the state's developmentally disabled people. It was separated from the Department of Children and Families and made into a freestanding department in 2004 by then-Gov. Jeb Bush. The agency provides home and community based services to nearly 30,000 Floridians through a Medicaid waiver. Another 20,000-plus Floridians are on a waiting list to obtain the waiver services.

Autism Society of Florida President Ven Sequenzia doesn't like Hansen's approach, saying if the agency narrows its scope and limits services, "you're doing exactly what you say you don't want to do. It's going to lead to more institutionalizations."

Hansen, who has spent the past decade in the governor's budget office as well as in the House and Senate budget committees, was brought on board to help set APD aright. The agency has been bedeviled by budget deficits in recent years. This past session the Legislature OK'd a law requiring the agency to bring its spending in line with its appropriations, which for fiscal year 2011-12 amounted to $810 million, or about $120 million less than what the agency spent the previous fiscal year. The Legislature also required the agency to cut provider rates by 4 percent and to freeze services so costs wouldn't go up.

Additionally, the 2011 Legislature required the department to submit a cost-cutting plan to it and Scott detailing how it would further cut spending. The report -- submitted Sept. 1 -- outlined a number of reductions the agency took during the summer, such as limiting transportation options to one round trip per day and reducing state payments for companion care.

Despite the Legislature's mandated rate cuts and the reductions APD identified this summer, the agency still will have a $55.2 million projected deficit at the end of fiscal year 2011-12. As of September the agency had a $7.5 million deficit.

Hansen outlined 10 additional options APD was considering to bring spending in line. Those include reducing rates APD pays for therapy assessments and nursing services to the same rates paid by the state Agency for Health Care Administrations for its Medicaid patients; reducing the rates it pays to home health agencies to 20 percent above the rates APD pays to solo practitioners who don't work for an agency; and to implement cost sharing requirements for parents of children who are served on the APD waiver.

Hansen also is submitting to the Legislature monthly reports of the agency's running surplus or deficit. Hansen, however, characterized the figure as an estimate he said is always wrong.

"I don't know if it's too high or too low," he said.




A Family Member HomeCare, A Hollywood, Florida Home Care Agency, provides home health care for disabled persons throughout Miami-Dade, Broward and Palm Beach counties, and 24 hour home care, costs health care, elderly health care, elderly home care, elderly home care services, elderly home health care, geriatric home care, health care, health care administration degree, health care agency, health care articles, health care management, health care marketing, health care policy, health care providers, health care service, health care services, health care solutions, health care survey, health care trends, home care, home care agencies, home care agency, home care rn, home care services, home care software, home care solutions, home health, home health agencies, home health agency, home health aid, home health aide, home health aide agencies, home health aide training, home health aides, home health aids, home health assistance, home health care, home health care agencies, home health care agency, home health care aide, home health care business, home health care costs, home health care products, home health care services, home health marketing, home health nurse, home health nursing, home health services, home health software, home health vna, hourly home care, hourly home health aide, information on nursing, low cost home care, masters health care administration, mba health care, mba health care management, medicare home care, medicare home health care, non medical home care, nursing, nursing agencies, nursing agency, nursing home care, nursing homes, partners home care, personal home care, private health care, private home care, risk management health care, senior health care, senior home care, senior home health care,medicare, medicaid, Florida, FL, nurse registry, nursing, seniors, aging, elder, elderly, senior, senior health, aged, aging services, social services, disabled, homemaker, companion, CNA, RN, geriatric, geriatrics, assisted living, nursing home, community resources, home health, nursing, financial, older adults, caregiver, assistance, assisted living, personal care, psych nurse, broward, davie, plantation, hallandale, coral springs, parkland, wilton manors, free health care, plantation, davie, hollywood, tamarac, ft. lauderdale, sunrise, weston, pembroke pines, coral springs, hallandale, miramar, oakland park, wilton manors, deerfield beach, parkland

Convened in July 2011 by Florida Governor Rick Scott after gut-wrenching reports of elder abuse and neglect at assisted living facilities throughout the State of Florida, Florida Governor Rick Scott's Assisted Living Workgroup will hold another public meeting on Friday, September 23, 2011 to continue its examination of the regulation and oversight of assisted living in Florida, for the purposes of developing recommendations to improve the State’s ability to monitor quality and safety in assisted living facilities and ensure the well-being of their residents. The September 23 meeting, which will be held at the University of South Florida, will run from 9 a.m. to 5 p.m.

The deadline to submit public testimony for this meeting was September 16, 2011. For more information,  contact: Faye Miller at (850)412-3735.

The meeting will be at:
University of South Florida

4202 E. Fowler Avenue, Gibbons Alumni Center,
Tampa, Florida 33620.

Directional and Parking Maps:

Alumni Center Directional Map [41kb .pdf]
Daily/Visitor Parking Map [405kb .pdf]

 Agenda [30kb pdf]

Meeting Materials:

Resources: 

Community Residential Care Issue Paper [172kb pdf]Assisted Living Facilities White Paper Introduction [540kb pdf]
Assessment and Complaint Process [148kb pdf]
The Florida Senate - Interim Report 2012-128


Regulations: 

Chapter 408, Part II, Florida Statutes (PDF) /(HTML)
Chapter 59A-35, Florida Administrative Code (HTML)

Chapter 429, Part I, Florida Statutes (PDF) /(HTML)
Chapter 58A-5, Florida Administrative Code (PDF) /(HTML)
Chapter 58T-1, Florida Administrative Code (HTML)



Meeting materials from August 8, 2011:

Agenda

Meeting Materials:

(TAB A) Sunshine Laws Presentation [394kb.ppt]
(TAB B) Workgroup Charter [95kb.pdf]
(TAB C) Rules of Order [95kb.pdf]
(TAB D) Press Release 07_25_11 [147kb.pdf]
(TAB E) Resolution No. R-586-11, Miami-Dade Board of County Commissioners [255kb.pdf]
(TAB F) Workgroup Objectives [38kb .pdf]


Additional Resources:

Stakeholder Presentations:

- AARP Remarks [55kb .pdf]
- Disability Rights Florida, Residential Options for People with Disabilities [166kb .pdf]
- Florida Assisted Living Association [77kb .pdf]
- Florida Association of Homes and Services for the Aging [291kb .ppt]
- Florida Council for Community Mental Health [40kb .pdf]
- Florida Health Care Association [380kb .pdf]
- Florida Life Care Residents Association [61kb .pdf]
- Long Term Care Ombudsman [168kb .pdf]
- Florida Peer Network, Inc. [77kb .pdf]
- Joan Andrade, Pinellas County [176kb .pdf]
- National Alliance on Mental Illness [176kb .pdf]
- Sean Cononie, Public Testimony [551kb .pdf]




News release from Florida Governor Rick Scott:

Workgroup Established to Examine Assisted Living Facilities

AHCA releases annual summary of ALF fines and sanctions

7/25/2011 Tallahassee, Fla.— Carrying out Governor Rick Scott’s directive to examine the regulation and oversight of assisted living facilities in Florida, the Agency for Health Care Administration (AHCA) announced the creation of the Assisted Living Workgroup. The workgroup’s objective is to make recommendations that will improve the monitoring and safety in assisted living facilities.

“Assisted living facilities play a critical role for many seniors by providing safe, community living accommodations for residents. While most facilities live up to those standards, we’ve seen reports of some that do not,” said Governor Scott. “The efforts of the workgroup will help ensure the safety and well-being of our residents.”

The workgroup includes Sen. Ronda Storms, Rep. Matt Hudson as well as health care association representatives, policy experts, advocates, and assisted living facility administrators. Larry Polivka, Director and Scholar in Residence at the Claude Pepper Foundation, has agreed to serve as Chairman of the workgroup. The first meeting of the Assisted Living Workgroup is scheduled for August 8 in Tallahassee.

“I look forward to working with the members of the workgroup in our mutual effort to better serve residents of assisted living facilities,” said Liz Dudek, AHCA Secretary. “I am also thankful for the participation of our state partners from the Office of the Attorney General, the State Fire Marshal’s Office, the Agency for Persons with Disabilities, and the Departments of Elder Affairs and Children and Families.”

The Agency also released its annual report of Assisted Living Facilities (ALFs) administrative fines, which highlights the over 300 ALFs penalized for serious or uncorrected violations. In addition, the annual summary of sanctions was released, which includes the 23 facilities whose licenses were revoked or denied at renewal or who had an emergency action imposed between July 1, 2010 and June 30, 2011.

For information about facilities AHCA licenses, please visit www.floridahealthfinder.gov.

The ALF annual report can be accessed at: http://ahca.myflorida.com/MCHQ/Long_Term_Care/FDAU/Reports.shtml.

For more information about the Assisted Living Workgroup, please visit http://ahca.myflorida.com/SCHS/ALWG2011/alwg2011.shtml.


For more information about a Miami-Dade, Broward and Palm Beach County home health care agency for seniors and other family members, contact Brian Gauthier at A Family Member HomeCare (954) 986-5090 or www.afamilymemberhomecare.com. Serving Coconut Creek Cooper City Coral Springs Dania Beach Davie Deerfield Beach Fort Lauderdale Hallandale Beach, Hillsboro Beach Hollywood Lauderdale Lakes Lauderdale-by-the-Sea Lauderhill Lazy Lake Lighthouse Point Margate Miramar North Lauderdale Oakland Park Parkland Pembroke Park Pembroke Pines Plantation Pompano Beach Sea Ranch Lakes Southwest Ranches Sunrise Tamarac Weston Wilton Manors Aventura Sunny Isles Beach Hialeah Miami Lakes Boca Raton Delray Beach.

Florida Governor Rick Scott's Commission on Review of Taxpayer Funded Hospital Districts is scheduled to meet on Tuesday, September 20, from 10 a.m. to 4 p.m. at the Florida Agency for Health Care Administration, (2727 Mahan Drive, Building 3, Conference Room “A”, Tallahassee, FL 32308 (map)https://www.flr​ules.org/gatewa​y/readFile.asp?​sid=6&tid=10371​451&type=1&File​=59.htm

Linda Quick, President of the South Florida Hospital and Healthcare Association, headquartered in Hollywood, Florida, will offer comments from her members' perspectives.

Jim Nathan, President of Lee Memorial Health System from Ft. Myers also will speak.
To view the complete September 20 agenda and meeting materials, click on the hyperlinks below:

Agenda [87kb pdf]
 Meeting Materials:

• DRAFT Minutes - September 6, 2011 [38kb pdf]
• Additional Financial Data [1,027kb xlsx]

The Commission was created by Governor’s Executive Order Number 11-63, to assess and make recommendations on the role of hospital districts, whether it is in the public’s best interest to have government entities operating hospitals and what is the most effective model for enhancing health-care access for the poor.

Any person interested in participating by telephone may dial: 1(888)808-6959, Participant Code: 8509223803.

If you have any difficulty accessing the teleconference, please call: Florida Relay Center’s Main Number at (850)412-3730.






For more information about Miami-Dade, Broward and Palm Beach County home health care for seniors and other family members, contact Brian Gauthier at A Family Member Home Care (954) 986-5090 or www.afamilymemberhomecare.com. Home Health, Home Health Care, Home Health Care Agency, Homecare, In-Home Caregiver, Home Nursing Care, Skilled Nursing, Certified Nursing Assistant, Home Health Aides, Home Health Aide, Senior Companion, Hollywood Home Health Care, Ft. Lauderdale Home Health Care, Miramar Home Health Care, Pembroke Pines Home Health Care, Hallandale Beach Home Health Care, Dania Beach Home Health Care, Cooper City Home Health Care, Fort Lauderdale Home Health Care Agency, Plantation Home Health Care, Weston Home Health Care, Bonaventure Home Health Care, Galt Ocean Mile Home Health Care, Imperial Point Home Health Care, Sunrise Home Health Care, Margate Home Health Care, Lauderhill Home Health Care, Lauderdale Lakes Home Health Care, Medicare Home Health Care, Medicare Home Health Care Agency, Dementia Care Services, Alzheimer's Home Health Care, Coconut Creek Home Health Care, West Park Home Health Care, Coral Springs Home Health Care, Parkland Home Health Care, Deerfield Beach Home Health Care, Pompano Beach Home Health Care, Hillsboro Beach Home Health Care, Lighthouse Point Home Health Care,King's Point Home Health Care, John Knox Village Home Health Care, Palm Aire Home Health Care, Lauderdale by the Sea Home Health Care, Oakland Park Home Health Care, Southwest Ranches Home Health Care, Sea Ranch Lakes Home Health Care, Aventura Home Health Care, Sunny Isles Beach Home Health Care, Surfside Home Health Care, Bahia Mar Home Health Care, Boca Raton, Delray Beach Home Health, Broward Alzheimer's Care, Ft. Lauderdale Dementia Care

September 15, 2011


WASHINGTON – U.S. Senator Herb Kohl, Chairman of the Senate Special Committee on Aging, has introduced legislation to address the unintended consequences of the U.S. Drug Enforcement Administration’s (DEA) heightened scrutiny of pain medication prescribing practices in nursing homes across America. As a result of the DEA policy, vulnerable patients are sometimes left to languish in pain as nursing home nurses and physicians strive to adhere to the Controlled Substances Act (CSA).


“The law should prevent suffering, not make it worse,” Kohl said. “Unfortunately, DEA’s crackdown has left elderly nursing home residents waiting for hours or even days for relief from excruciating pain. This legislation would help end these needless and avoidable delays.”


Under Kohl’s Nursing Home Resident Pain Relief Act of 2011, a physician may authorize the administrator of the long-term care facility to designate nurses and other appropriately licensed health professionals to act as facility designees. On the physician’s oral instruction, the facility designees may order and administer pain-relieving controlled substances to residents whose medical conditions warrant immediate pain relief. The bill also requires written records documenting each step in the process, and provides strong criminal and civil penalties for diverting drugs or violating the recordkeeping requirements.


Last year, Kohl held an Aging Committee hearing calling attention to the unintended consequences of DEA’s heightened scrutiny of prescribing practices in long-term care settings. Kohl has been working closely with U.S. Attorney General Eric Holder and stakeholders to find a solution that satisfies the law enforcement goals of the DEA and meets the needs of ailing nursing home patients.


Historically, nurses were able to call urgently needed prescriptions into pharmacies upon a physician's order over the phone. Pharmacies would fill the order; residents would get their pain medication; and, physicians would follow up with written confirmation of the prescription. However to comply with the CSA, DEA now requires physicians to directly issue prescriptions in writing for all pain medications before they can be dispensed, even in emergency circumstances.


Last year, DEA issued a policy statement to provide a way for nursing home residents to access some kinds of medication more quickly. Under the new policy, a nursing home’s licensed health care professionals may, on a physician’s behalf, transcribe the physician’s oral prescription for Schedule III, IV or V medications to a pharmacy to be filled. Kohl’s legislation would amend the CSA, to provide the agency with the statutory authority needed to allow licensed health care professionals to transmit prescriptions for Schedule II controlled substances, the category under which nearly all pain medications fall.

To view this release on Senate.gov, go to:  http://aging.senate.gov/hearing_detail.cfm?id=334069&


For more information about a Miami-Dade, Broward and Palm Beach County home health care agency for seniors and other family members, contact Brian Gauthier at A Family Member HomeCare (954) 986-5090 or www.afamilymemberhomecare.com. Serving Coconut Creek Cooper City Coral Springs Dania Beach Davie Deerfield Beach Fort Lauderdale Hallandale Beach, Hillsboro Beach Hollywood Lauderdale Lakes Lauderdale-by-the-Sea Lauderhill Lazy Lake Lighthouse Point Margate Miramar North Lauderdale Oakland Park Parkland Pembroke Park Pembroke Pines Plantation Pompano Beach Sea Ranch Lakes Southwest Ranches Sunrise Tamarac Weston Wilton Manors Aventura Sunny Isles Beach Hialeah Miami Lakes Boca Raton Delray Beach Home health care agencies home health care agency home health care services in home health care senior home health care home health care providers health care agency home health care jobs at home health care home health care agencies in florida home health care florida medicare home health care health care agencies home health care elderly home health agency home health care service home care agencies home health care companies home health care agency florida private home health care home health agencies elderly home health care home care agency what is home health care home health care agencies in broward county home health services home health care cost accessible home health care florida home health care home health aide agencies in home health care services home health care business home health aide home health care nursing home health care provider home health care employment in home health care jobs home health aide jobs home health aides home health care medicare in home health care agencies home health care seniors. We work with all South Florida hospitals and rehabilitation clinics to ensure safe transitions to in-home health care and provide attendants, caregivers, certified nursing assistants (CNA), companions, HHAs, homemakers. Providing homecare in Miami-Dade County, Broward County and Palm Beach County Member of Society of Certified Senior Advisors, National Association for HomeCare and Hospice; Home Care Association of Florida; American College of HealthCare Executives, Volunteer Broward, Hospice by the Sea, Rotary Club of Fort Lauderdale, Joseph Meyerhoff Senior Center, HomeHealthCompare, home health advance beneficiary notice, Florida Agency for Health Care Administration

New initiatives led by campaign to cut waste will save Medicaid waste and strengthen partnership with states to reduce improper unemployment insurance payments
WASHINGTON – At the White House on September 14, 2011, Vice President Joe Biden convened a cabinet meeting to discuss waste reduction at federal agencies as part of the administration’s Campaign to Cut Waste. The vice president announced a new initiative to fight waste in Medicaid that is estimated to save taxpayers over $2 billion, unveiled new efforts to track state progress in reducing improper unemployment insurance payments, and directed each Cabinet secretary to undertake a waste and efficiency review that will target unnecessary, wasteful, and inefficient federal spending.

“Today’s announcements on cutting waste in Medicare, Medicaid and Unemployment Insurance shows that we can make our government more efficient and responsible to the American people,” said Vice President Biden. “If we’re going to spur jobs and economic growth and restore long-term fiscal solvency, we need to make sure hard-earned tax dollars don’t go to waste.”

Joined by Health and Human Services (HHS) Secretary Kathleen Sebelius, the vice president discussed a new initiative to fight waste and fraud in Medicaid that will save taxpayers an estimated $2.1 billion. HHS today released its final rule for the Medicaid Recovery Audit Contractor Program, a waste-cutting program created by the Affordable Care Act. HHS projects the program will save $2.1 billion over the next five years, of which $900 million will be returned to states. The new program is based on the successful Medicare Recovery Audit Contractor program, which the vice president announced has already recovered nearly $670 million to date in 2011 – increasing the taxpayer dollars recovered by nearly 800 percent compared to 2010.

“Today we are building on an already successful program that targets improper payments in our health care programs and recovers those dollars, making Medicare and Medicaid more reliable and responsible,” said HHS Secretary Kathleen Sebelius. “We simply can't afford to see even one penny of our health care dollars wasted and expanding this program will help us reach that goal."

The vice president also unveiled new Labor Department efforts to reduce improper Unemployment Insurance payments and hold states accountable for progress as part of the administration’s comprehensive efforts to crack down on waste, fraud and abuse. Department of Labor Secretary Hilda Solis joined the vice president to discuss the department’s next steps in combating these improper payments:
A New Transparency Initiative to Make It Clear Where States Stand: The Department of Labor is launching a new effort to clearly show every state’s performance on improper payments. The agency unveiled an online map that will show citizens their state’s payment errors, which types of problems are driving its error rate, and the steps it has taken to address its rate.

Comprehensive Turnaround Plans for High Priority States: DOL has identified six high priority states -- Virginia, Indiana, Colorado, Washington, Louisiana, and Arizona -- based on their high rate of improper payments. DOL is working with these states to ensure they develop a comprehensive turnaround plan to reduce their improper payments. In addition, high-performing states will be paired with these states to offer guidance and aid as the plans are developed and implemented. High priority states will be subject to additional monitoring and technical assistance until they achieve an improper payment rate under 10 percent and sustain that performance for at least six months.

New Awards to States to Automate and Improve Unemployment Insurance Data Collection: The Department of Labor today awarded nearly \ 92 million to 42 states to implement waste-cutting initiatives and improve the Unemployment Insurance program, including upgrading technology systems to more accurately collect data and process claims.

These steps build on other efforts to address improper payments the administration launched earlier this year.

“The Unemployment Insurance system is a unique partnership between the federal government and the states. States bear the responsibility of operating an efficient and effective benefits program, but as partners the federal government must be able to hold them accountable for doing so,” said Secretary Solis. “These new measures, demonstrate our commitment to working closely with states to ensure the integrity of the system, turnaround underperforming programs and save taxpayer dollars.”

Finally, as part of efforts to cut waste and inefficient spending, the vice president asked the Cabinet to report back on wasteful and inefficient agency spending on travel, auto fleets, publications, and office equipment and supplies, from cell phones to software, or in any other areas identified by agencies.

The vice president highlighted the Department of Homeland Security’s Efficiency Review as a model effort. Since 2009, the agency has identified more than $1 billion in cost avoidances and implemented 30 efficiency initiatives across the agency – from buying software licenses in bulk to using government offices for meetings instead of renting private space. As a result of these savings and other ongoing efficiency initiatives, the agency’s 2012 budget request included more than $800 million in reductions. As he did with the Recovery Act, the vice president called on secretaries to be personally involved in these reviews, and will hold cabinet members personally responsible for the performance and results of the process.

“Over the last two years, we have made an unprecedented commitment to efficiency in order to support frontline operations by building a culture of fiscal discipline and accountability throughout the department,” said Secretary Napolitano. “Through the Department of Homeland Security’s Efficiency Review, we’ve taken a hard look at how we do business, and identified ways to maximize the effectiveness and efficiency of limited taxpayer dollars we receive.”

As part of the launch of the Campaign to Cut Waste in June, the president asked the vice president to take on a new role holding the Cabinet accountable for cutting waste in their agencies – part of the administration’s ongoing effort to make government more efficient and responsive to the American people. The vice president will hold regular Cabinet waste cutting meetings and is working closely with Office of Management and Budget Director Jack Lew and the administration’s Chief Performance Officer Jeffrey Zients to root out waste across the agencies and make government work for America’s families.

“We have made great strides in the last two years – shrinking contract spending for the first time in 13 years, identifying $3 billion in cost reductions from information technology projects across government, and getting rid of property we no longer need,” said Lew. “Particularly now in these challenging fiscal times, it is critical that each and every member of the Cabinet take personal ownership of aggressively rooting out waste and being vigilant stewards of taxpayer dollars.”

To go to this story on the HHS Web site, click here.

On September 12, 2011, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius Secretary Kathleen Sebelius proposed new rules that would expand the rights of patients to access their health information through the use of health information technology (IT). Specifically, the new rules would empower patients and allow them to gain access to test results reports directly from labs. They would ensure that labs covered by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) provide such information, upon request, directly to patients or their personal representatives. The announcement came at the kick-off of the first-ever HHS Consumer Health IT Summit, which brought consumers, providers, and the public and private sectors together to discuss how best to empower consumers to be partners in their health and care through health IT.

“When it comes to health care, information is power. When patients have their lab results, they are more likely to ask the right questions, make better decisions and receive better care,” said Secretary Sebelius.“This Summit offers a unique opportunity for the public and private sectors alike to share strategies to improve consumer access to their health information, while safeguarding the privacy and security of their data.”

The Notice of Proposed Rulemaking (NPRM), jointly drafted by the Centers for Medicare & Medicaid Services, the HHS Office for Civil Rights (OCR), and the Centers for Disease Control and Prevention, proposes to amend the Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations and HIPAA privacy regulations to strengthen patients’ rights to access their own laboratory test result reports.

Secretary Sebelius also announced the appointment of Leon Rodriguez as the new Director of the Office for Civil Rights. Rodriguez brings his Department of Justice experience to HHS and will be dedicated to ensuring consumers’ health information is kept private and secure.

“Consumers need to know that private and secure access to their health information is a given,” stated OCR Director Rodriguez. “The privacy and security of health data will be a top priority for OCR during my tenure.”

Secretary Sebelius also unveiled today an innovative voluntary Personal Health Record (PHR) Model Privacy Notice, which creates an easy-to-read, standardized template allowing consumers to compare and make informed decisions based on their privacy and security policies and data practices about PHR products. The new template is similar to the Nutrition Facts Labels in that it presents certain complex information in a simple way to improve transparency and consumer understanding about data practices. By making this Model Privacy Notice available, PHR companies can help build greater trust in PHRs.

Today’s Summit included more than 25 health care stakeholder organizations, representing consumers, large and small practice providers as well as insurers and health IT industry leaders, that have pledged to empower consumers by making it easier for them to get secure access to their health information to engage more fully in their health.

“As technology improves more aspects of our daily lives, it makes sense to marry cutting-edge technology with our medical and personal health records so that we can improve both the quality and efficiency of the care that people receive,” said National
Coordinator for Health Information Technology, Farzad Mostashari, M.D., Sc.M. “We are encouraging everyone to visit our website at www.HealthIT.gov to read our newly released Strategic Plan that sets forth our comprehensive plans for consumer empowerment for the next five years.“

The Summit highlighted vital benefits of electronic health records and health IT, including:
Health IT empowers patients. For example, people at risk for heart attacks may use mobile health applications to manage their weight, diet, and medication adherence.
Health IT can facilitate lasting quality improvements, which can lead to greater efficiency and cost savings in the long-term.
Health IT is driving innovation in all parts of consumers’ lives – from new interactive applications to devices like digital pedometers and other devices that capture important health information from everyday experiences.
Health IT helps coordinate better care, and can be a powerful tool if you or a loved one is managing a serious medical condition.
Health IT has robust security and all users, from patients to caregivers to doctors, can easily and safely access and share health information electronically.
Health IT may help diagnose health problems sooner, avoid medical errors and provide safer care which can result in lower costs.

“We are at a critical moment in time when we can either choose to innovate, or lag behind in care,” said Dr. Mostashari. “A commitment by health care stakeholders to support health IT and provide greater consumer access to their health information is the first step toward a healthier future.”

In the coming year, ONC will work with health care stakeholders to further consumer access to information and empower consumers to become active participants in their health. The new website, www.HealthIT.gov creates dedicated consumer-oriented information that describes the benefits of health IT, provides consumer health education materials and will be a valuable resource for learning about new advances in health IT.

For more information about the proposed amendments to the CLIA and HIPAA Privacy regulations, please visit https://www.cms.gov/apps/media/fact_sheets.asp.

 

National Prevention Strategy Announcement

June 16, 2011 Secretary Sebelius and U.S. Surgeon General Regina M. Benjamin join other administration officials to announce the National Prevention and Health Strategy, as part of the Affordable Care Act. Sebelius and other administration officials delivered remarks before there was a Q-and-A session and Panel Discussion about the strategy. Read the press release.

For more information about a Miami-Dade, Broward and Palm Beach County home health care agency for seniors and other family members, contact Brian Gauthier at A Family Member HomeCare (954) 986-5090 or www.afamilymemberhomecare.com. Serving Coconut Creek Cooper City Coral Springs Dania Beach Davie Deerfield Beach Fort Lauderdale Hallandale Beach, Hillsboro Beach Hollywood Lauderdale Lakes Lauderdale-by-the-Sea Lauderhill Lazy Lake Lighthouse Point Margate Miramar North Lauderdale Oakland Park Parkland Pembroke Park Pembroke Pines Plantation Pompano Beach Sea Ranch Lakes Southwest Ranches Sunrise Tamarac Weston Wilton Manors Aventura Sunny Isles Beach Hialeah Miami Lakes Boca Raton Delray Beach Home health care agencies home health care agency home health care services in home health care senior home health care home health care providers health care agency home health care jobs at home health care home health care agencies in florida home health care florida medicare home health care health care agencies home health care elderly home health agency home health care service home care agencies home health care companies home health care agency florida private home health care home health agencies elderly home health care home care agency what is home health care home health care agencies in broward county home health services home health care cost accessible home health care florida home health care home health aide agencies in home health care services home health care business home health aide home health care nursing home health care provider home health care employment in home health care jobs home health aide jobs home health aides home health care medicare in home health care agencies home health care seniors. We work with all South Florida hospitals and rehabilitation clinics to ensure safe transitions to in-home health care and provide attendants, caregivers, certified nursing assistants (CNA), companions, HHAs, homemakers. Providing homecare in Miami-Dade County, Broward County and Palm Beach County Member of Society of Certified Senior Advisors, National Association for HomeCare and Hospice; Home Care Association of Florida; American College of HealthCare Executives, Volunteer Broward, Hospice by the Sea, Rotary Club of Fort Lauderdale, Joseph Meyerhoff Senior Center, HomeHealthCompare, home health advance beneficiary notice, Florida Agency for Health Care Administration

HEALTH CARE
Maxim to Pay $150 Million Fine for Health Care Fraud


by Maggie Fox
Updated: September 12, 2011 | 3:14 p.m.
September 12, 2011 | 2:58 p.m.


Maxim, a company that provides help from licensed nurses to home health aides, has admitted to $61 million worth of federal fraud and agreed to pay civil and criminal penalties totaling $150 million, the Justice Department said on Monday.

Nine people who admitted defrauding Medicaid and the Department of Veterans Affairs are named in the settlement, including a Florida nurse who submitted false Medicaid bills and the mother of the child the nurse claimed to have cared for, as well as a home health aide in South Carolina who admitted to filling out faked time cards.

“Maxim has agreed to pay approximately $70 million to the federal government and approximately $60 million to 42 states – including more than $2.7 million to be paid to the state of New Jersey,” the Justice Department said in a statement. The company also will pay $20 million in criminal penalties.

“In addition, the company must also retain and pay an independent monitor, who will review Maxim’s business operations and regularly report concerning the company’s compliance with all federal and state health care laws, regulations, and programs,” according to the DOJ statement.

New Jersey Attorney General Paula Dow said the investigation began with a complaint from a Medicaid patient in New Jersey who filed a whistle-blower lawsuit.

“The investigation revealed that the submission of false bills to government health care programs was a common practice at Maxim from 2003 through 2009. During that time period, Maxim received more than $2 billion in reimbursements from government health care programs in 43 states based on billings submitted by Maxim,” DOJ said.

“Fraudulent billing for services not rendered uses patients as pawns in a game of corporate greed that puts cash over care and wastes precious taxpayer dollars,” added Tony West, Assistant Attorney General for the Civil Division at DOJ. “At a time when we're all looking for ways to reduce public expenditures, settlements like this one recapture taxpayer dollars lost to fraud and abuse, and help ensure that funds are available for the vital health care programs and services that people depend on day in and day out.”

The Medicare Fraud Strike Force, a joint effort of the Health and Human Services and Justice departments, has been working hard to make high-profile arrests. Preventing Medicare fraud is an area the Obama administration has tried to highlight as a benefit of the 2010 health-reform law. Last week the strike force indicted 91 people in connection with $295 million worth of fraud.

Rules finalized last year empower patients to designate their own visitors, including same-sex partners




On September 7, 2011, the U.S. Department of Health and Human Services (HHS) announced new guidance to support enforcement of rules that protect hospital patients’ right to choose their own visitors during a hospital stay, including a visitor who is a same-sex domestic partner. These rules, finalized by the Centers for Medicare & Medicaid Services (CMS) in November, apply to all hospitals that participate in Medicare and Medicaid. The guidance also supports enforcement of the right of patients to designate the person of their choice, including a same-sex partner, to make medical decisions on their behalf should they become incapacitated.

"Couples take a vow to be with each other in sickness and in health and it is unacceptable that, in the past, some same-sex partners were denied the right to visit their loved ones in times of need," said HHS Secretary Kathleen Sebelius. "We are releasing guidance for enforcing new rules that give all patients, including those with same-sex partners, the right to choose who can visit them in the hospital as well as enhancing existing guidance regarding the right to choose who will help make medical decisions on their behalf.”

The rules updated the Conditions of Participation (CoPs), which are the health and safety standards all Medicare- and Medicaid-participating hospitals and critical access hospitals must meet, and apply to all patients of those hospitals even if they are not on Medicare or Medicaid. Among other things, the CoPs require hospitals to explain to all patients their right to choose who may visit them during their inpatient stay, regardless of whether the visitor is a family member, a spouse, a domestic partner (including a same-sex domestic partner), or another type of visitor, as well as their right to withdraw such consent to visitation at any time.

Existing CoPs also protect the rights of hospital patients to have representatives who can act on their behalf. HHS has updated the guidance for these rules to emphasize that hospitals should give deference to patients’ wishes concerning their representatives, whether expressed in writing, orally, or through other evidence, unless prohibited by state law. The guidance issued today is intended to make it easier for family members, including a same-sex domestic partner, to make informed care decisions for loved ones who have become incapacitated.

CMS today sent a letter to State Survey Agencies, which conduct on-site inspections of hospitals on behalf of CMS. The letter highlights the equal visitation and representation rights requirements and directs SSAs to be aware of the guidance when evaluating hospitals' compliance with CoPs.

“This announcement is another step toward equal rights for all Americans, and it is another step toward putting the patient at the center of our health care system,” said CMS Administrator Donald M. Berwick, M.D. “All patients should be afforded the same rights and privileges when they enter our health care system, and that includes the same opportunity to see their significant other.”

In other news of interest to the LGBT community, the Health Resources and Services Administration (HRSA), another agency of the Department of Health and Human Services, today announced a $248,000 grant to the Fenway Institute to create a National Training and Technical Assistance Center to help community health centers improve the health of lesbian, gay, bisexual and transgender (LGBT) populations.

For more information on the CMS rules issued in November, please visit: http://www.hhs.gov/news/press/2010pres/11/20101117a.html

For the letter sent to State Survey Agencies, please visit: http://www.cms.gov/SurveyCertificationGenInfo/PMSR/itemdetail.asp?itemID=CMS1251864.


For more information about a Miami-Dade, Broward and Palm Beach County home health care and homecare agency for seniors, Alzheimer's patients, sufferers of dementia and other family members needing home health care services or in-home health aides, contact Brian Gauthier at A Family Member HomeCare (954) 986-5090 or visit www.afamilymemberhomecare.com.

To Register for this Tuesday, September 6 (7:00 PM - 8:00 PM EDT) Complimentary Webinar on Choosing Home Care from the National Association for Home Care and Hospice, click here.


The webinar, "A Basic Primer in Home Care," will help families learn how they can "choose home" for the seniors or loved ones who, because of frailty, need some assistance in their lives with daily living.

Help Choose Home. Three simple words that can mean all the difference for a frail loved one.

When frailty means additional help is needed, helping a loved one choose home means helping recuperate faster or helping to feel secure, familiar and helping to maintain a sense of independence.

In-home care has been a part of the health care delivery system for well over a century, and we want to help you choose home so you understand what in-home care is, how to get it, what it costs, and the possibilities that it presents for long-term care.

On Tuesday, September 6, 2011 from 7 p.m. to 8 p.m. (ET), two experts on senior issues, the Private Duty Homecare Association (PDHCA) and Caring.com, have come together to share with you some options to help your loved one choose home when care is needed.

Our first discussion, facilitated by Merrily Orsini, MSSW from PDHCA and co-presented with aging expert Mary Koffend from Caring.com, is a Basic Primer on Home Care. You will learn the ins and outs of home care and hear information on:

• What is in-home care?
• Why would you want to use in-home care?
• Types of in-home care
• The importance of respite care for families
• Who pays for in-home care?
• Frequently asked questions
• Where to find help

A Family Member HomeCare is a Proud Member of the National Association for Home Care and Hospice.


For more information about a Miami-Dade, Broward and Palm Beach County home health care agency for seniors and other family members, contact Brian Gauthier at A Family Member HomeCare (954) 986-5090 or www.afamilymemberhomecare.com. Serving Coconut Creek Cooper City Coral Springs Dania Beach Davie Deerfield Beach Fort Lauderdale Hallandale Beach, Hillsboro Beach Hollywood Lauderdale Lakes Lauderdale-by-the-Sea Lauderhill Lazy Lake Lighthouse Point Margate Miramar North Lauderdale Oakland Park Parkland Pembroke Park Pembroke Pines Plantation Pompano Beach Sea Ranch Lakes Southwest Ranches Sunrise Tamarac Weston Wilton Manors Aventura Sunny Isles Beach Hialeah Miami Lakes Boca Raton Delray Beach Home health care agencies home health care agency home health care services in home health care senior home health care home health care providers health care agency home health care jobs at home health care home health care agencies in florida home health care florida medicare home health care health care agencies home health care elderly home health agency home health care service home care agencies home health care companies home health care agency florida private home health care home health agencies elderly home health care home care agency what is home health care home health care agencies in broward county home health services home health care cost accessible home health care florida home health care home health aide agencies in home health care services home health care business home health aide home health care nursing home health care provider home health care employment in home health care jobs home health aide jobs home health aides home health care medicare in home health care agencies home health care seniors. We work with all South Florida hospitals and rehabilitation clinics to ensure safe transitions to in-home health care and provide attendants, caregivers, certified nursing assistants (CNA), companions, HHAs, homemakers. Providing homecare in Miami-Dade County, Broward County and Palm Beach County Member of Society of Certified Senior Advisors, National Association for HomeCare and Hospice; Home Care Association of Florida; American College of HealthCare Executives, Volunteer Broward, Hospice by the Sea, Rotary Club of Fort Lauderdale, Joseph Meyerhoff Senior Center, HomeHealthCompare, home health advance beneficiary notice, Florida Agency for Health Care Administration

Biometrics speed admissions and reduce mistakes while cutting fraud and ID theft

September 4, 2011
www.SunSentinel.com