OIG: CMS should look closer at hospice billing

The Department of Health & Human Services' Office of the Inspector General (OIG) has recommended taking a closer look at billing for hospice care.

The OIG has asked that the Centers for Medicare & Medicaid Services (CMS) examine hospice billing practices following a series of studies about the industry, which concluded that Medicare spending on hospice increased some 70 percent between 2005 and 2009, topping $4.3 billion a year. Moreover, a huge proportion of hospice patients were being treated by for-profit hospice organizations, and a large number of them were coming from nursing homes, meaning they were likely to spend longer periods of time in hospice than patients from other sources.

"Some hospices may be seeking out beneficiaries with particular characteristics, including those with conditions associated with longer but less complex care," said the OIG in a recent report. "Such beneficiaries are often found in nursing facilities. By serving these beneficiaries for longer periods, the hospices receive more Medicare payments per beneficiary, which can contribute to higher profits."

However, a major trade group for the hospice industry is concerned that this could affect access to care, according to a Healthcare Finance News article.

"We support the scrutiny. We also want to make sure that people are not denied access to care because of a regulatory barrier that might be put up in their way," Judi Lund Person, vice president of compliance for the National Hospice and Palliative Care Organization, said in the article.

For more:
- read the OIG statement
- read the Healthcare Finance News article