Home Health & Hospice

According to its recently-released 2015 work plan, what areas of hospice care will the Office of Inspector General focus on in the coming year?

Homecare Insider, November 10, 2014

For hospices, the OIG will focus on:

  • Hospice services in assisted living facilities. The agency will review the extent to which hospices serve Medicare beneficiaries who reside in assisted living facilities (ALFs)—a population that has the longest lengths of stay in hospice care. Stay durations in this setting require further monitoring and analysis, according to the Medicare Payment Advisory Commission. Consequently, the OIG will study the lengths of stay, levels of care provided, and common terminal illnesses of beneficiaries who receive hospice care in ALFs. The agency specifies that this work will contribute to CMS’ obligation under the Affordable Care Act (§3132) to reform the hospice payment system.
  • The appropriateness of general inpatient care claims. The OIG will review the use of hospice general inpatient care, including the appropriateness of claims and the content of election statements for hospice beneficiaries in this realm. The agency states that it will also study applicable medical records to address concerns that this level of hospice care is being misused.