Eli's Hospice Insider

More than $620 million should have come out of hospices’ pockets, audit claims.

It’s not just Medicare that is putting payments for non-hospice services to hospice enrollees under the microscope.

The Massachusetts Office of the State Auditor audited claims paid by MassHealth for dual-eligible members who were receiving hospice care from January 2015 through July 2019, the OSA says in a release. “During this period, MassHealth paid $620,584,171 in claims for hospice-related services to non-hospice providers for dual-eligible members,” the state office declares.

MassHealth paid for durable medical equipment, professional health services, ambulance, and inpatient services that should have been covered under the Medicare hospice benefit, the state determined. Last October, it reminded hospices they must submit “both a MassHealth Hospice Election Form and a Medicare Hospice Election Form” upon election and revocation, according to the release.