Home Health & Hospice Week

Shore up your documentation to address this medical review hot spot. If your hospice hasn't taken a good look at how it determines--and documents--patients' eligibility for the Medicare hospice benefit, you're fair game for everything from payment recoupments to fraud and abuse investigations. There's no shortage of reasons for hospices to pay close attention to patients' hospice eligibility,an issue that has moved to the front burner for payers and prosecutors. First, there's the specter of the $24.8 million SouthernCare qui tam lawsuit settlement involving allegations that the hospice kept patients on the benefit who didn't need it (see Eli's HCW, Vol. XVIII,No. 5, p. 34). Experts also predict the Recovery Audit Contractor program will likely target the hospice eligibility issue, which provides easy pickings. Not only that: Providers that consistently have longer-than-average lengths of stay will likely prompt a medical review, if a hospice shows persistently higher-than-average LOS compared to [...]