Eli's Hospice Insider

Published on Sat May 01, 2010 PDF

• Expect more scrutiny of your claims, thanks to President Obama directing HHS to cut Medicare's improper payment rate in half by 2012. The president wants the rate measured by the Comprehensive Error Rate Testing (CERT) program to be reduced as part of HHS's overall crackdown on Medicare waste, fraud, and abuse, HHS says in a June 8 letter to state attorneys general.

HHS and the Department of Justice also will hold regional fraud prevention summits that will consist of panels and training sessions for federal and state officials, law enforcement, providers, caregivers, seniors, etc.

DOJ has also asked all 93 U.S. Attorneys "to convene regular health care fraud task force meetings to facilitate the exchange of information with partners in the public and private sector, and to help coordinate anti-fraud efforts," the letter continues. Those meetings will start taking place by August.

More enforcement ahead: "We will use the new tools and resources provided by the Affordable Care Act to further crack down on fraud," HHS and OIG pledge in the letter. "These include new  criminal and civil penalties, enhanced information technology to track and prevent fraud in the first place, and new authorities to prevent bad actors from billing Medicare and Medicaid."

• Difficulty accessing hospice care isn't only a problem in this country. There is not enough quality palliative care available for dying cancer patients in Canada, according to a special report by the Canadian Cancer Society (CCS) on end-of-life care. That's despite cancer being the leading cause of death in the country (29 percent).

While most dying patients choose to die at home, about 55 percent of deaths occur in hospitals in Canada. "One reason for this is because community-based services are not available for dying people," CCS says in a release. The report is at www.cancer.ca.

• You can brush up on the basics of signature requirements -- and avoid denials -- with a new tool from one regional home health intermediary.

For example: Stamped signatures are never acceptable for Medicare documents, RHHI Cahaba GBA reminds providers in a new quick reference tool. But faxed and electronic signatures are OK. The new tool also goes over attestation requirements. The tool is online at www.cahabagba.com/rhhi/education/materials/quick_signature.pdf.