Eli's Hospice Insider
Expect More Scrutiny If OIG Gets Its Way
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Nursing home-hospice interactions could raise red flags.
The Centers for Medicare & Medicaid Services' monitoring of hospice claims for patients who are nursing home residents isn't strong enough for the HHS Office of Inspector General, according to the OIG's new Compendium of Unimplemented Recommendations.
Why: In a review, 82 percent of hospice claims for beneficiaries in nursing facilities did not meet Medicare coverage requirements -- yet Medicare paid nearly $1.8 billion for these claims, the report stated. Of those 82 percent, 33 percent didn't meet election requirements and 63 didn't meet plan of care requirements.
But nursing home scrutiny isn't all the OIG wants to see for hospices. "We continue to recommend that CMS seek statutory changes for the frequency of hospice certification and seek regulatory or statutory changes to establish specific requirements for enforcement remedies for poor hospice performance," the report urges.
Resource: The compendium is at http://go.usa.gov/462.
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