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Home health care flying by night
Fraud in Miami-Dade is so bad that the state may impose new rules to govern companies.
Published December 13, 2007
TALLAHASSEE - Fraud at fly-by-night home health agencies is so rampant in Miami-Dade County that the state should consider putting a limit on how many new people can get into that field and increase fines for fraud, a state agency said Wednesday.
Agency for Health Care Administration officials told lawmakers that the number of companies registering as home health care providers in the Miami area has exploded, going up 232 percent since 1999, compared to a 28.5 percent increase in the rest of the state.
At the same time, complaints about insufficient care and fraud have increased, said Jeff Gregg, chief of the state's Bureau of Health Facility Regulation.
Some providers go into business to provide home health care services and are never inspected by the government, because they actually close up shop too quickly, Gregg said.
While the increase in fraud has been going on for several years, it seems to have gotten worse in the last few years, said Bobby Lolley, president of the board of the Associated Home Health Industries of Florida, which represents providers.
"Something has to be done," Lolley told the Senate Health Regulation Committee. "For the good providers that are being pushed out. In Miami-Dade, there's getting to be more bad guys than good guys."
The committee chairman said lawmakers need to consider putting a cap on new players in the business, but also said agency resources need to be redirected quickly to try to have an impact in the meantime.
Gregg suggested to the panel that a limit of five new licenses per month might help, but state health care officials said later that the legislation is a work in progress and the number could change. The agency is also likely to propose limiting the number of home health agencies registered at any one address to one and significantly increasing fines for fraud in the field.
The rise in fraud has coincided with a move to find more ways to provide routine care - help with bathing or dressing, for example - in peoples' homes, rather than moving them to nursing homes or other institutional settings.
But it also followed the elimination in 2000 of a previous requirement that certain health care agencies show a need for their services before they can operate. After that requirement ended, the floodgates for unscrupulous providers seemed to open up, agency officials said in a report delivered to the committee.