Trump throws the baby out with the bathwater in an attempt to fight fraud

Earlier this year, to fight Medicare fraud, the Trump administration launched a six-month moratorium on all new Medicare home health and hospice providers nationwide, regardless of geography, compliance history, or any confirmation of fraud.While America’s care-at-home provider community strongly supports efforts to root out Medicare fraud, waste, and abuse — and is an active partner with the Trump administration to strengthen program integrity — concerns with this blanket policy remain intact. Most concerning is the threat to patient access that this moratorium creates, particularly in areas where capacity is already limited and healthcare options are scarce. Other justified concerns include the moratorium’s unintended impacts on patient health outcomes, competition, and innovation.Patient access is the provider community’s primary concern. In communities where patient demand is growing and provider capacity is already stretched thin, the current freeze on new enrollment means longer wait times, reduced availability, and fewer choices for patients. We worry this could lead to delays in hospital discharges, transfer to less appropriate care settings, and potentially lower quality of life for patients who need home health or hospice. This concern is heightened in rural and underserved areas where home care is sometimes a patient’s only healthcare option. Make no mistake — America’s honest, high-quality care at home providers want fraudulent actors out of the Medicare program as much as the Trump administration does. We recognize that isolated instances of fraud in the Medicare program have harmed patients, undermined public trust, and wasted countless government and taxpayer resources. But a broad-based approach unfairly threatens the reputation and stability of compliant, hardworking, and compassionate providers who are delivering care the right way in homes across the country.Fraud in home-based care, though limited, is concentrated in precise geographies and among specific entities, yet the nationwide moratorium doesn’t reflect this reality. This sledgehammer approach is not the appropriate tool for the targeted challenges at hand. Stronger program integrity can be achieved through data-driven strategies, boots-on-the-ground surveys, and enforcement of existing oversight mechanisms that root out fraudsters without limiting patient access to care or penalizing high-quality providers operating in good faith.Since the moratorium was announced in May, I have heard from many honest providers who are experiencing adverse impacts because of this policy, including: Underserved communities left without an at-home care provider despite efforts by a compliant, national provider to open new home health agencies in healthcare deserts; stalled improvement and expansion plans with significant financial investments left in limbo until the moratorium is lifted; and restricted changes of ownership, risking closures and further limiting capacity in select markets. The National Alliance for Care at Home — the largest trade group representing the U.S.’s care-at-home providers — is actively working with the Trump administration and Congress to advance more data-driven and risk-based solutions, including more effective oversight.We welcome continued industry collaboration with Dr. Mehmet Oz and his team at the Center and Medicare & Medicaid Services to share ideas, discuss oversight processes, and home in on the most effective solutions for patients, providers, government, and taxpayers.As we approach six months of the home health and hospice moratorium this fall, we urge CMS not to extend this broad measure. We strongly believe a more targeted mechanism is needed to achieve the Trump administration’s goal of fighting fraud while protecting access to quality care at home.WE’RE BEING DEFRAUDED OUT OF $1 MILLION EVERY SINGLE MINUTE. IT’S TIME TO STOP THE BLEEDINGIt is widely recognized that patients prefer home-based care, yet blanket policies that limit access to care at home deny this option to many individuals. This is not fair to patients and families, and it is not fair to the healthcare professionals ready to deliver this care. Better solutions are on the table. We urge the Trump administration to work with us to put them in place. We can fight fraud while also protecting our community’s ability to meet the mounting home care needs of more American families.Jonathan D. Fleece is president & CEO of Empath Health based in Lakewood Ranch, FL. Empath Health is a not-for-profit health network redefining healthcare through Full Life Care, supporting chronic, post-acute, end-of-life, and grief care needs and a member of the National Alliance for Care at Home.