Issue link: https://read.dmtmag.com/i/50323
HME NEWS / JANUARY 2012 / WWW.HMENEWS.COM Keeping the clowns out of your company Lisa Wells and Carrie Robinson give advice on how to qualify your employees BY LISA WELLS W HILE PRESENTING at the 2011 HME News Business Summit in Septem- ber, several people asked for advice on ways they could better verify the skills and backgrounds of their job applicants. Immediately, my thoughts turned to Car- rie Robinson, a cost-cutting financial consultant who I previously worked with in the HR technology indus- try. For years, Carrie and I worked together to create and deliver client solutions at HR technology compa- nies like ChoicePoint, Ceridian and First Advantage. I oversaw the solutions' design while Carrie advised employers on how to best maximize the resulting services to improve their hiring process. "When evaluating job candidates, the two largest areas where you find conflicts and confusion are on their resume in education and employment his- tory," Robinson says. The good news is that there are a wide variety of online tools that can help you check the facts. Assessment tests can help you evaluate whether or not a job applicant truly has the skills neces- sary for the position. Different kinds of assessment tests are available to review a candidate's personality, character traits and technical skills. You can even have custom ones created for the specific nature or requirements of your open positions. "By using assessment tests, you might discover that you have the perfect candidate for invento- ry management, but they may not have the right skill set or personality for assisting customers with advanced healthcare needs. Having that information helps you leverage that person's strengths to your company's advantage," Robinson advises. Some of the leading providers of online assess- ment tests include Previsor, First Advantage and Kenexa. Kenexa offers a fantastic website called Prove It!, www.proveit.com, that contains more than 1,200 skills and behavioral assessments for clerical, software, technical, call center, industrial, financial, legal and medical positions. "I always recommend assessment tests along with a complete background and employment verifica- tion search," Robinson adds. "The cost of making a bad hiring decision is far worse than the fee of No whiny talk I JUST FINISHED reading the Medtrade Special Report section ("How can Medicare save money," HME News October 2011). It was a great idea collecting stories and interviews that offer some poignant points of view throughout this section from true leaders in our industry. Sylvia Toscano's piece about controlling costs with technology really caught my attention. Her offering, as well as some of the others in the special section, really seemed to demonstrate exquisite industry lead- ership because the content was full of realistic solutions for both "us" (HME community) and "them" (CMS). There was no whiny, poor us, victimization talk. Just well thought out solutions and win-win ideas. Kudos to HME News. Best edition ever in my opinion. —Rick James, director of operations, Health Reliance, Richmond, Va. using a qualified recruiter and a thorough back- ground check." This is especially true in the healthcare industry, where your employees often come in contact with vulnerable or high-risk patients, as well as a vari- ety of personal health information. In fact, the OIG Compliance Program recommends that healthcare workers be carefully screened before any hiring deci- sion is made. "I've received numerous requests from healthcare organizations to screen per JCAHO standards," Rob- inson says. "There is confusion in this area because there is not a 'standard' screening element or silver bullet search due to the variety of healthcare organiza- tions and positions hired within these organizations." The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) com- pliance guidelines were established to mitigate fraud and abuse in the healthcare industry. HHS says that compliance programs should include "the investiga- tion and remediation of identified systemic problems and the development of policies addressing the non- employment of retention of sanctioned individuals." One of the best tools available to meet these mini- mum compliance guidelines is with the Fraud and Abuse Control Information Search [FACIS] search. This search is an available item through most repu- table background screening organizations. A FACIS search meets the federal government's requirements set forth in the OIG's Compliance Program and con- tains information reported by the FDA, DEA, Tri-Care and more than 800 state and federal sources. By using this specific search, you can discover healthcare-spe- cific sanctions, including exclusions, debarments, suspensions, revocations, terminations, probations, restrictions, limitations and letters of reprimand. "When reviewing an applicant's background, in addition to verifying their skills, I personally advise my clients to go back at least five years or back through their last three employers to get a true pic- ture of that person," Robinson says. HME Lisa Wells is the director of marketing for UroMed. For more help on hiring practices, please contact Carrie Robinson at 404-918-4496 or email consult.carrie@gmail.com. Carrie has more than 12 years of human resources and financial analysis experience in the medical industry. Commentary AUDITS: PART I The stage is set BY JEFFREY S. BAIRD, Esq. T Editor's note: This introductory overview is Part I of a five-part series. Part II will address prepayment reviews; Part III will address post-payment audits; Part IV will compare post-payment audits and prepayment reviews conducted by DME MACs with those conducted by ZPICs; and Part V will discuss contractor abuses and the steps that AAHomecare and industry stakeholders are taking to correct the abuses. HE HME industry is young. In its present form, it has been around for about 30 years. Compare this to physi- cians, hospitals and pharmacists who have been around for thousands of years. The industry grew up relatively unregulated. HCFA (now CMS) did not know what we did. And then approximately seven years ago it is as if CMS woke up one morning and asked: "Who are these people and why are we paying them money?" Added to this was bad publicity ema- nating from Operation Wheeler Dealer in Houston and blatant fraudulent schemes in South Florida. Another challenge is that few people with CMS and on Capitol Hill have ever set foot in an HME company. Young, healthy people go to physicians, hospitals and pharmacies. As a general rule, senior citizens (whose bodies break down as they age) use HME companies. The 28-year-old legislative staffers and the 50-year-old CMS employees have had no reason to visit an HME company, much less understand what an HME company does. As the government is famous for doing, it overreacted. In a rel- atively short time-frame, the industry got hit with increased regulations, decreased reimbursement, competitive bidding, and aggressive post-payment audits and prepay- ment reviews. The pendulum will eventually swing back toward the middle. Until that time, however, the HME industry will have to deal with intrusive government scrutiny. What is interesting is that the demand for what the industry has to offer will only increase expo- nentially. There are 78 million baby boomers (people born between 1946 and 1964). They are retiring at the rate of 10,000 per day. The boomers will live until they are 85 years old, their bodies will start breaking down at 70, they will expect a good quality of life until they die, and they will not want to live in a long-term care facility—they will want to live at home. The mantra of healthcare cost containment will be to keep Medicare beneficiaries away from physicians and hospitals. The demand, then, for what HME pro- viders have to offer will be huge. I call this the "irresistible force" (demand) meets the "immovable object" (Medicare is broke). And so while we are in strange times, the future is bright for well- run, innovative HME providers. One of the biggest challenges facing providers today is preparing for and responding to post-payment audits and prepayment reviews. There is abundant contractor abuse in how the audits and reviews are being conducted. AAHomecare and industry stakeholders are working with CMS to correct these abuses. Nevertheless, audits and reviews will be a permanent part of the landscape. Why is there such an increase in audits and reviews? Audits and Jeff Baird reviews are moneymakers for the government. For every dollar expended by the government to chase a recoupment, the govern- ment recovers many more dollars. There is an increase in utilization of HME; this is to be expected in light of the "graying of America." Generally speaking, HME is expensive. This, by itself, will capture the government's attention. Contractor auditors are becoming more sophisticated in reviewing HME claims. It is a priority of CMS to uncover and prevent fraud in the Medicare fee-for-service pro- gram. Healthcare providers (not just HME providers) have become the new bogeyman to the government. The bogeyman used to be "Big Oil"….then "Big Tobacco"….then "Big Pharma"…..and now "fraudulent healthcare providers." Recovering money from fraudu- lent healthcare providers makes for an easy sound bite for politi- cians. HME Jeffrey S. Baird, Esq. is chairman of the Health Care Group at Brown & Fortunato, P.C., a law firm based in Amarillo, Texas. He can be reached at (806) 345-6320 or jbaird@bf-law.com. 13 LETTER TO THE EDITOR