Home Health & Hospice Week

Hospice:

Hospice Claims For Nursing Facility Residents Under Fire

Hospices with lots of nursing home patients are suspicious, new OIG report says. You may have to think long and hard about furnishing hospice services to nursing home patients if a new recommendation by the OIG gets adopted. In a new report, the HHS Office of Inspector General calls for lawmakers and the Centers for Medicare & Medicaid Services to cut payments to hospices for patients that reside in nursing homes. "The current payment structure provides incentives for hospices to seek out beneficiaries in nursing facilities, who often receive longer but less complexcare," the OIG says. "To lessen this incentive, CMS should reduce Medicare payments for hospice care provided in nursing facilities, seeking statutory authority, if necessary." Hospices and nursing homes may be providing duplicative services, the OIG implies. "Unlike private homes, nursing facilities are staffed with professional caregivers and are often paid by third-party payers, such as Medicaid," the [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more

Other Articles in this issue of

Home Health & Hospice Week

View All