Yesterday, we highlighted the home health services section of the 2015 OIG Work Plan. Today, we’ll take a closer look at the hospice services section of the Work Plan:
For beneficiaries living in assisted living facilities, the OIG will review the level of services provided, including the length of stay, level of care received and common terminal illnesses. This information is necessary for CMS to reform the hospice payment system, collect data relevant to revising hospice payments, and develop quality measures. Furthermore, hospice care may be provided to individuals and their families in various settings. These settings include the beneficiary’s place of resident, such as an assisted living facility. Typically, assisted living facility residents have the longest lengths of stay in hospice care, thus requiring more monitoring and examination.
The OIG will also assess the appropriateness of hospices’ general inpatient care claims and the content of election statements for hospice beneficiaries who receive general inpatient care. The OIG will review hospice medical records to address concerns that this level of hospice care is being misused. Beneficiaries may revoke their election of hospice care and return to standard Medicare coverage at any time.
Click here to see the plan.