Home Health & Hospice Week

Eight-figure repayment due to lack of GIP documentation.

You’d better make sure your records supporting General Inpatient care are airtight, or you could find yourself in the same painful position as one Florida hospice.

Pensacola-based Covenant Hospice Inc. has agreed to pay the government $10.1 million for alleged overbilling of GIP care in 2009 and 2010, the Department of Justice says in a release. The announcement came on the heels of the DOJ’s largest criminal health care fraud takedown in history (see related story, p. 178).

The difference: Covenant self-reported its billing mistakes after discovering them, the hospice maintains in a release. “During a review of its records in August 2010, unintentional billing and documentation errors were found to have occurred during 2009 and 2010,” the hospice says. “Hospice patients received the level of care needed, but documentation was insufficient to support the billing rates. Covenant Hospice immediately contacted the Department of Justice to correct these errors.”

“We initiated extensive staff training on proper medical record documentation to ensure compliance while continuing to provide the highest quality of care for our patients and families,” Liz Kuehn, VP of organizational excellence and corporate compliance, says in the release.

Nevertheless: “It is the responsibility of the hospice provider to ensure that a patient’s medical record contains the appropriate documentation to support the level of hospice care that is billed,” the DOJ chides in its release.

In addition to the financial hit, Covenant has had to absorb reputational injury. “During recent days, the reputation of Covenant Hospice has come under scrutiny,” the provider acknowledges in its release.

Covenant serves about 800 patients daily in southern Alabama and the Florida panhandle.