OIG-recommended new enforcements in Hospice Care

Key Takeaway:

New enforcements in hospice care have been put in place from late 2014. These are the result of observations from the OIG of rampant abuse and focus on specific areas of abuse.

New enforcements in hospice care have been laid out in two distinct and notable changes relating to oversight and enforcement by the terms of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, which was passed by the American Congress.

Increase in frequency of survey and certification inspections

By the terms of IMPACT, the frequency of survey and certification inspections for hospice providers has been increased. New enforcements in hospice care require hospices to be subject to a certification inspection at a frequency of no less than once every three years. Earlier, the State agencies performing the inspections could decide on the frequency arbitrarily.

New enforcements in hospice care spelt out in IMPACT have changes for hospices in which a high proportion of patients that receive care for six months or more. These centers have to have their hospice programs reviewed. The Centers for Medicare & Medicaid Services (CMS) need to set a limit on the percentage or number of patients receiving medical care for six months or above that lead to a medical review.

Reasons for changes into new enforcements in hospice care

New enforcements in hospice care concentrate specifically on the two vital areas of frequency of certification inspection and extended care for patients because it was noticed that it was in these areas that high scale abuses existed at hospices. The Office of the Inspector General (OIG) was continually monitoring these abuses and zeroed in on the exact areas that needed improvements in the form of new enforcements in hospice care.

These new enforcements in hospice care target providers who claimed to be treating patients with either dubious diagnoses or unauthentic certifications of the existence of terminal illness.

Enhanced whistleblowing opportunities

To help the new enforcements in hospice care check widespread abuse and misuse, the federal government arms the relevant provisions of Obamacare with more powers, investigative tools and funding to check these malpractices. One of the major features that have been introduced as part of new enforcement in hospice care is whistleblowing. It is now more profitable than even before to become a whistleblower exposing misappropriations in hospice finance and other activities.

Other provisions of new enforcements in hospice care

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