Home Health & Hospice Week

You should know how you stack up against your peers, because regulators are looking at that information to target their investigative resources (see related story, p. 235).

You should track information such as your top 10 diagnoses and your average length of stay, suggests Robert Markette Jr. with Hall Render in Indianapolis. "The OIG can easily check that data and would target based on that data," he says.

Likely targets: Based on the hospice final payment rule for 2014, you can bet that hospices with a large ratio of claims with a single diagnosis or with dementia codes the Centers for Medicare & Medicaid Services warns against will top the list, experts say.

Another red flag for authorities is likely a high ratio of patients in nursing homes. The HHS Office of Inspector General issued a report two years ago casting grave suspicions on so-called "high percentage hospices," which were providing two-thirds or more of their hospice care to Medicare patients in nursing facilities (see Eli’s HCW, Vol. XX, No. 30). In its 2014 payment rule, CMS suggests that it will reduce hospice payment rates for nursing home patients in the future.

You can check some of that data in the Comparative Billing Reports issued by CBR contractor SafeGuard Services. A sample report is at www.safeguard-servicesllc.com/cbr/documents/CBR004_ Hospice_sample.pdf.