Consultant’s letter panics south Florida provider

Problem provider’ list creates problem for director

Following January’s cover story on the Office of Inspector General’s (OIG) so-called "problem provider list,"Hospital Home Healthreceived a phone call from a frantic hospital-based home care director in south Florida who had been told her agency was among the 698 providers named on the list.

"We didn’t know we were on it, and we don’t know why we’re on it, or what to do about it," complained the director, who learned of the agency’s dilemma in a letter from a California consulting firm. This is the same consultant who made this list public after obtaining a copy through the Freedom of Information Act.

Since publication of our January issue, the OIG released a "general statement" about the "problem provider list," reiterating much of what was covered in HHHWe obtained a copy of the statement from Ben St. John, a spokesman for the OIG in Washington, DC. The OIG statement maintains that the list was only a work sheet used for its July 28, 1997, report titled "Home Health: Problem Providers and Their Impact on Medicare."

As far as the list is concerned, the OIG says, "Provider names themselves were not necessary or relevant to accomplish the purposes of this study — to identify and help correct systemic weaknesses in the administration of the Medicare home health benefit."

The OIG statement goes on to say the study "was never intended to, nor did it, produce, a hit list’ of providers to be investigated by the Office of Inspector General.

"We obtained the provider numbers in order to collect summary data on the study’s universe and to draw a random sample for in-depth study. It was the activity under the provider numbers that revealed the systemic weaknesses that supported the conclusions in the report, not the names of the home health agencies themselves.

"Identifying particular home health agencies was not the purpose of the study."

The statement advises that no one should draw any conclusions about a home health agency’s present status with the OIG. "In particular," the OIG says, "the released work sheet does not establish whether a particular home health agency has ever committed a crime or is currently the subject of an investigation, nor should it be used to draw conclusions about a home health agency’s present status with respect to the Medicare program."

Instead of worrying about an outdated work sheet, agency directors would be better off developing corporate compliance plans, which the OIG is encouraging and which just happen to be the focus of this month’s newsletter. n