Eli's Hospice Insider

Published on Mon Mar 18, 2019 PDF

Hospices can thank the HHS Office of Inspector General for new scrutiny on high-paying claims.

Medicare’s Supplemental Medical Review Contractor Noridian Healthcare Solutions “is conducting post-payment review of claims for general inpatient hospice billed on dates of service from January 1, 2017 through December 31, 2017,” Noridian says on its website.

In a March 2016 report, the OIG “found that hospices commonly billed for General Inpatient Care (GIP) when the beneficiary did not have uncontrolled pain or unmanaged symptoms,” the SMRC says. “According to the report, Hospices inappropriately billed Medicare over $250 million for the GIP level of care.” The OIG asked Noridian to undertake the GIP review, the contractor says.

More information is at www.noridiansmrc.com/current-projects/01-009.