Home Health & Hospice Week

Industry News:

OIG Homes In On Hospice Claims In Nursing Facilities

The amount of noncompliance might come as a surprise. Medicare paid approximately $1.8 billion in 2006 in hospice claims for beneficiaries in nursing facilities that didn't meet at least one Medicare condition of requirement. That's the news from a recent Office of the Inspector General report that also found that 33 percent of nursing facilities' hospice claims didn't meet election requirements, and a whopping 63 percent didn't meet plan of care requirements. Another 4 percent didn't meet certification of terminal illness requirements. In a companion piece, the OIG examined the hospice services provided to the beneficiaries in nursing facilities and found that Medicare paid $2.59 billion at an average of $960 per week per beneficiary. Hospices provided nursing services on 96 percent of claims, home health aide services for 73 percent of claims, and medical social services for 68 percent of claims, the report found. Drugs were provided in 96 [...]
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