OIG
Hospice Survey Process Revised
The long-awaited revised hospice survey process is now available via a recent Quality, Safety & Oversight (QSO) Group memo, QSO-23-08-HOSPICE. The memo updates Appendix M of the Centers for Medicare & Medicaid Services (CMS) State Operations Manual which lays out the hospice survey process and the interpretive guidelines surveyors use to assess a hospice’s compliance […]
Read MoreMedicare Providers Did Not Always Comply With Federal Requirements When Billing for Advance Care Planning
Medicare providers that billed for advanced care planning (ACP) services in an office setting did not always comply with Federal requirements, according to a new report from the Office of Inspector General (OIG). Specifically, the OIG investigation found that of the 691 ACP services associated with their sample, Medicare providers complied with Federal requirements for […]
Read MoreOIG: Home Health Responded to COVID Creatively, but Challenges Persist
Key issue of telehealth remains Home health agencies (HHAs) developed strategies to respond to challenges during the COVID-19 pandemic, including providing new incentives to maintain staff and seeking alternative sources of personal protective equipment, finds a new report from the Office of Inspector General (OIG). The report also concluded that HHAs were helped by regulatory flexibilities and expanded telehealth usage, and recommended […]
Read MoreHospices Urged to Participate in CMS Pilot to Test Transmission of Hospice Election Data to Part D Plans
For more than a decade, the Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services Office of the Inspector General (OIG), and other policymakers have noted with concern the growth in Medicare spending outside of the hospice benefit, while patients are on hospice care. One area of particular concern is […]
Read MoreHospices Urged to Participate in CMS Pilot to Test Transmission of Hospice Election Data to Part D Plans
For more than a decade, the Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services Office of the Inspector General (OIG), and other policymakers have noted with concern the growth in Medicare spending outside of the hospice benefit, while patients are on hospice care. One area of particular concern is […]
Read MoreHospices Urged to Participate in CMS Pilot to Test Transmission of Hospice Election Data to Part D Plans
For more than a decade, the Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services Office of the Inspector General (OIG), and other policymakers have noted with concern the growth in Medicare spending outside of the hospice benefit, while patients are on hospice care. One area of particular concern is […]
Read MoreHospices Urged to Participate in CMS Pilot to Test Transmission of Hospice Election Data to Part D Plans
For more than a decade, the Centers for Medicare & Medicaid Services (CMS), the Department of Health and Human Services Office of the Inspector General (OIG), and other policymakers have noted with concern the growth in Medicare spending outside of the hospice benefit, while patients are on hospice care. One area of particular concern is […]
Read MoreOIG Workplan to Include OASIS Falls Reporting & Post-acute Transfer Policy
The Department of Health & Human Services Office of the Inspector General (OIG) reported the addition of a new study and a new audit that should be of interest to the home health and hospice communities. These alerts to the public via daily updates of new audits and reports is part of the OIG Work Plan. The […]
Read MoreOIG Finds Inappropriate Service Denials by MAOs
An Office of Inspector General (OIG) report determined that Medicare Advantage Organizations (MAOs) sometimes delayed or denied Medicare Advantage beneficiaries’ access to services, even though the requests met Medicare coverage rules. MAOs also denied payments to providers for some services that met both Medicare coverage rules and MAO billing rules. In the report, Some Medicare Advantage Organization Denials […]
Read MoreOIG Releases Brief on Potential Inappropriate Payments to Nonhospice Providers
NAHC is creating materials to assist member hospices on this subject. Please stay tuned to NAHC Report The Health & Human Services’ (HHS) Office of the Inspector General (OIG) released a data brief, Medicare Payments of $6.6 Billion to Nonhospice Providers Over 10 Years for Items and Services Provided to Hospice Beneficiaries Suggest the Need for […]
Read MoreOIG Releases Brief on Potential Inappropriate Payments to Nonhospice Providers
NAHC is creating materials to assist member hospices on this subject. Please stay tuned to NAHC Report The Health & Human Services’ (HHS) Office of the Inspector General (OIG) released a data brief, Medicare Payments of $6.6 Billion to Nonhospice Providers Over 10 Years for Items and Services Provided to Hospice Beneficiaries Suggest the Need for […]
Read MoreOIG Planning for Nationwide Hospice Eligibility Audit in 2023
A nationwide audit of hospice eligibility, with a focus on Medicare beneficiaries who have not had an inpatient ER or hospital stay prior to starting hospice care is planned for 2023 by the Office of the Inspector General (OIG) of the Department of Health & Human Services. According to OIG, previous compliance audits on hospice […]
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