Medicare Claims for Unrelated Services Put Hospices at Risk

August 18, 2022

Payouts for non-hospice services provided to Medicare beneficiaries has been in the billions. Investigators have urged regulators to ramp up oversight of potentially inappropriate billing practices. Hospices usually is not the one billing these inappropriate charges, it affects them anyway.

As a result, hospices can expect to see more auditing and scrutiny of what costs are deemed “unrelated” to end-of-life care, according to Judi Lund Person, vice president of regulatory and compliance for the National Hospice and Palliative Care Organization.

“We are seeing increased scrutiny of Medicare spending outside the benefit in Parts A, B, or D after a patient has elected their Medicare Hospice Benefit,” Lund Person told Hospice News in an email. “Additional scrutiny about these expenditures is on the rise, and providers should expect to see questions from the [Medicare Administrative Contractors (MACs)] and other auditors about why some items were considered to be unrelated. There will always be gray areas with relatedness based on diagnoses and treatments specific to an individual patient.”

Click here for the full article.

About Corridor

For over 30 years, Corridor has partnered with home-based care providers, delivering powerful solutions to support the unique challenges of caring for patients in the home. Our team of operating executives, clinicians, and nationally renowned industry experts have run provider organizations and resolved the same challenges you face.

To receive the most important industry updates, insights and news impacting home health and hospice, please make sure to sign up for our weekly newsletter.

 

Explore Corridor’s Solutions

Share This Story, Choose Your Platform!