The best way to fight fraudulent activity is to prevent it. We communicate clear standards and expectations for employee activities, and require periodic, mandatory compliance training for all employees. Compliance is a consistent focus at Amedisys, with employees trained upon hire, as regulations change, and re-trained at least annually to reinforce compliance standards.
Knowledge and adherence to our compliance standards is expected of all Amedisys employees, and any employee with questions or concerns is encouraged to seek guidance from their supervisor, the Compliance staff, or through our 24/7 compliance hotline (1-800-464-0020).
Amedisys engages in frequent review of company activities to confirm compliance with all laws and regulations. Reviews include care center assessments, clinical operations audits, conditions of participation audits, Compliance Manager audits, internal audits, Sarbanes Oxley audits, and annual external audits of consolidated financial statements for the company. Further, we perform periodical medical records reviews throughout the year to ensure ongoing adherence to the Conditions of Participation, Medicare coverage and eligibility guidelines, and compliance with other regulations.
To help identify and prevent compliance issues, we have integrated automatic coding reviews into our patient record technology, which flag certain coding patterns for further review by a team of experts. We also contact a random sample of 100 active employees each month for a confidential phone interview with the Compliance department, and conduct an exit survey of all employees who leave the company.
Simply put, Amedisys maintains a position of zero tolerance when it comes to fraud, both for those directly violating compliance standards and those who fail to report or investigate suspected violations.
Health care fraud is a crime that affects providers, physicians, taxpayers and most worryingly, patients’ access to care. As an industry leader, Amedisys takes a strong stance against fraud in home health care.
In home health care, a relatively few unscrupulous individuals commit the vast majority of fraud, and there are commonsense steps Congress can implement to eliminate these abuses. We staunchly support the Partnership for Home Healthcare’s proposed anti-fraud reforms, which would save taxpayers as much as $700 million per year without impacting patients’ access to care.