Home Health & Hospice

Weekly roundup

Homecare Insider, April 4, 2016

OIG finds $268M in Medicare hospice overpayments

Recent investigations by the Office of Inspector General (OIG) have shown a number of instances in which hospices inappropriately billed Medicare for hospice general inpatient care (GIP). Misuse of GIP includes care being billed but not provided and beneficiaries receiving care they do not need. Hospices billed one-third of GIP stays inappropriately, costing Medicare $268 million in 2012, according to an OIG study released last week.

The OIG study was based on data from a medical record review of a stratified random sample of all GIP stays in 2012. OIG analyzed the results of the medical record review to estimate the percentage of GIP stays that were billed inappropriately. The office also studied Medicare Part D data to identify the drugs paid for by Part D and provided to beneficiaries during GIP stays.

Source: OIG

Join our home health book review group!

HCPro is seeking enthusiastic home health administrators and directors, clinical supervisors, staff educators, and coding and billing experts to join an ad-hoc group interested in reading and reviewing prepublication drafts of books and training materials in your areas of interest and expertise.

Our editors will send you periodic emails listing upcoming projects available for outside review. If you’re interested, just let us know. We’ll send reviewing guidelines and give you an idea of our timeframe. If it works for you, we’ll send the draft chapters as they’re available, and a printed copy of the book when it’s complete. In addition, you will be recognized as a reviewer inside the printed book. We might also ask for your feedback on topics in your area of expertise.

Please have a minimum of five years of home health experience and be in an educational, supervisory, or leadership role within your organization.
For more information or to sign up as a reviewer, please send an email including your areas of interest and expertise to Tami Swartz at tswartz@hcpro.com.

CMS updates advance care planning FAQ

There are no limitations on the settings in which advance care planning (ACP) codes. ACP services may be appropriately furnished in a variety of settings depending on the needs and condition of the beneficiary. This is one of the ACP-related facts presented in the FAQ posting on CMS’ website. The codes are separately payable to the billing physician or practitioner in both facility and non-facility settings and are not limited to particular physician specialties.

The new FAQs also address how often ACP services can be reported for the same patient. “There are no limits on the number of times ACP can be reported for a given beneficiary in a given time period,” the FAQ states. “When the service is billed multiple times for a given beneficiary, [CMS] would expect to see a documented change in the beneficiary’s health status and/or wishes regarding his or her end-of-life care.”

Source: CMS

FBI: Hospice owner told staff to kill patients

The owner of a Dallas-area hospice ordered nurses to increase medication dosages for patients to speed their deaths and maximize profits, according to an FBI affidavit that was revealed last week. The affidavit alleges that Brad Harris, owner of Novus Health Services in Frisco, Texas, ordered higher dosages for at least four patients. However, it’s unclear whether any deaths occurred as a result.

The affidavit reportedly refers to a search warrant, which refers to a September 2015 FBI raid on the hospice. The warrant alleges Harris sent text messages and emailed staff telling them to increase doses to certain patients. In at least one instance, an employee refused to follow orders to increase a dosage, according to the warrant.

Harris has not been charged. The FBI last week declined to say whether an investigation is ongoing.

Source: Modern Healthcare, Associated Press