For home-care fraud watchers, President Clinton's latest actions are just home-care crackdown du jour.
The feds have had home-care Medi-care fraud in their sights for more than two years now, as hardly a week goes by without a new anti-fraud initiative.
In May 1995 Clinton christened "Operation Restore Trust," an anti-fraud initiative that named home health as one of its primary targets.
In June 1995 HHS' inspector general's office issued a special fraud alert to consumers targeting abuses by home-care providers.
In May 1997 HHS announced that Operation Restore Trust was being expanded to 17 states from five and ultimately would be implemented in every state.
For some in the industry, Clinton's speech last week to the Service Employees International Union was like watching a rerun.
Attorney Larri Short said home care is garnering all the attention because it's a rapidly growing segment of the federal Medicare budget.
"My impression is that the industry believes this is overkill," said Short, with Arent, Fox, Kintner, Plotkin and Kahn in Washington.
New fraud initiatives are a mixed blessing for providers, said Lee Hoffman, president and chief executive officer of All Care VNA, based in Lynn, Mass.
"It worries me that (the initiatives seem) to heighten the anxiety that there's rampant fraud and abuse because there is not," she said. "But if (they keep) those out of the business who are not doing it the right way, then that's good."
Short said all the attention has created some negative feelings.
"I think (home-care providers) are feeling not only picked on but persecuted," she said.
The government already has demonstrated its low tolerance for Medicare fraud by home-care providers. Some notable examples include:
In June 1996 Robert "Jack" Mills, the founder of the former ABC Home Health Services, was sentenced to 7 1/2 years in federal prison and ordered to pay almost $10 million in restitution after he and his company were convicted of falsely billing Medicare more than $1 million.
The government's ongoing fraud investigation of Columbia/HCA Healthcare Corp. includes a probe of the company's home-care operations.
In August a federal grand jury returned a 102-count indictment charging 12 people in Florida with defrauding Medicare of $15 million.
Also in August the Justice Department filed suit against two Tennessee home-care providers, accusing them of overbilling Medicare at least $30 million.