Medicare Compliance & Reimbursement

Hospices: Get OIG approval prior to offering free services.

Just because the OIG put its stamp of approval on a program in which volunteers offered non-skilled services to terminally ill patients who did not qualify for hospice care, don’t imagine that you have carte blanche to offer free services to patients. These free services can be viewed as kickbacks.

1. Delineate services. A big reason the HHS Office of Inspector General approved a hospice’s request for a free bridge program is because it offered low-monetary-value services provided by volunteers, hospice legal experts point out. Don’t just assume you can water down your regular hospice services.

The "OIG has stressed that the program must be for volunteered services … of a non-skilled, non-homecare or hospice-like content," counsels attorney Deborah Randall with Deborah Randall Consulting in Washington, D.C. The programs the OIG has approved are "fundamentally a friendly visitor/companion type service with some shopping and transportation," she tells Eli.

Bottom line: Do not include any professional or paraprofessional services, Randall advises.

2. Eschew social work. You must sidestep the common landmine of excluding nursing services while including social worker services. "This means no case worker/social worker assessments or support visits/calls," Randall says.

3. Avoid aides. Don’t include hands-on personal care either, Randall warns.

4. Monitor. "Compliance officers should monitor closely the implementation of this kind of program," Randall offers. That’s especially true "when a marketing angle either inspires it or creeps in."

5. Ask the OIG. "Whenever free services are offered, it is wise to submit the arrangement to the OIG for approval before implementing it," says attorney John Gilliland II with The Gilliland Law Firm in Indianapolis.