Medicare Crackdown Targets California : Fraud: Clinton tells delegates at conference on aging about state-federal campaign. It focuses on home health agencies and nursing homes in five states.

President Clinton announced on Wednesday a special federal-state campaign to crack down on Medicare fraud in California and four other big states where complaints are rising about alleged chicanery in nursing homes and home health care agencies.

Speaking to enthusiastic delegates at the White House Conference on Aging, Clinton pledged to protect Medicare from crooks and cheats while also keeping it safe from political and budgetary pressures.

His remarks sought both to assure and woo senior citizens, whose interests have become the latest element in the continuing tug of war between congressional Republicans and the Administration. Each side is hoping to position itself as the protector of the nation’s elderly.

Yet unlike the debate that has raged between the two sides in recent days over proposed Medicare cuts and the budget, Clinton’s tone was restrained and relatively conciliatory. “We must find a way to make this system work better . . . and that deals with the genuine problems the Congress faces with our budgetary situation.”

Under the campaign, federal inspectors, state investigators, insurance company officials and volunteer ombudsmen who visit nursing homes under federal programs will meet for the first time in special task forces to ferret out fraud, Administration officials said.

Some of the prime targets will include doctors who peek into a room and then bill for an examination of the patient, nursing homes where patients undergo surgeries without their knowledge or permission and vendors who charge excessive prices for equipment ranging from wheelchairs to prosthetic devices.

This week’s aging conference is the first by the White House since 1981. Past sessions have helped pave the way for major government programs, such as Medicare itself. But the objectives this year appear far more modest, given the effects of the nation’s budget problems, public distrust of government and the new Republican majority in Congress.

On the budget, neither the Administration nor Congress has offered any detailed plan to deal with the financial problems of the Medicare trust fund, which is projected to fall into bankruptcy by the year 2002.

Republicans are demanding that the President issue a blueprint for Medicare solvency, while he has said that he will not discuss the topic until they unveil a budget plan. Democrats claim that Republicans want to balance the budget at the expense of Medicare.

Clinton told the more than 2,200 delegates that as soon as Congress presents a budget, “we will then talk about where we go from there and what we can do so that I can make sure that your interests and the interests of people coming behind you are protected.”

The campaign to combat Medicare fraud, called Operation Restore Trust, will focus on California, Florida, New York, Texas and Illinois, which together have 40% of the nation’s 36 million Medicare beneficiaries.

For every dollar spent on chasing and prosecuting crooks, the government will recover $6 to $8, the President said. “This is a win-win situation for everybody, except the perpetrators of fraud,” Clinton said. “And it’s about time they lost one.”

The top areas for fraud investigations will be home health care, nursing homes and durable medical equipment.

Under Medicare rules, home health care, authorized by doctors, should be restricted to people who cannot leave their home. It can include anything from physical therapy to a visit by an aide who helps the patient walk and take medicine. This is the fastest growing category of spending for Medicare.

Investigators are finding unauthorized visits and cases where agencies billed for services but did nothing, said Elizabeth Abbott, associate regional administrator in California for the federal Health Care Financing Administration, which runs Medicare.

Times staff writers Janet Hook in Washington and Linda Feldman in Los Angeles contributed to this story.