OIG Planning for Nationwide Hospice Eligibility Audit in 2023

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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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HHS Financial Report for 2021 Identifies Increases in Hospice Payment Error Rates

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Increases not “statistically significant”, according to HHS On an annual basis, the Department of Health & Human Services (HHS) issues a financial report that provides fiscal and high-level performance results that allow for the assessment of HHS’ performance over the previous fiscal year.  Last week HHS issued its FY2021 HHS Agency Financial Report (Report) containing an overview […]

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HHS Financial Report for 2021 Identifies Increases in Home Health, Hospice Payment Error Rates

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Increases not “statistically significant”, according to HHS On an annual basis, the Department of Health & Human Services (HHS) issues a financial report that provides fiscal and high-level performance results that allow for the assessment of HHS’ performance over the previous fiscal year.  Last week HHS issued its FY2021 HHS Agency Financial Report (Report) containing […]

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OIG Reports on Home Health Agency Infection Control Audit

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An audit of eight home health agencies (HHAs) by the Office of the Inspector General (OIG) found that most had infection control policies and procedures that met the stndards set by the Centers for Medicare & Medicaid Services (CMS) and followed CMS COVID-19 guidance to safeguard Medicare beneficiaries, caregivers, and staff during the coronavirus pandemic, according […]

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HHS to Evaluate Home Health Agencies on Emergency Communication Plans

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The Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) has included in their workplan a report to evaluate home health agencies’ (HHA) compliance with Emergency Preparedness Conditions of Participation (EP CoPs). The report is expected to be issued in 2023. Natural disasters such as hurricanes, floods, and fires […]

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New NAHC Webinar: CMS Plans Sweeping Survey Reforms & Implications for Hospice Providers

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Register Tuesday, July 13, 2021 1:00-2:00pm Eastern Sponsored by Homecare Homebase In mid-2019, the Department of Health and Human Services’ Office of the Inspector General (OIG) issued reports that raised considerable concerns in Congress, at the Centers for Medicare & Medicaid Services (CMS) and among hospice stakeholders. While the OIG’s findings indicated that a relatively small percentage of […]

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New NAHC Webinar: CMS Plans Sweeping Survey Reforms & Implications for Hospice Providers

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Register Tuesday, July 13, 2021 1:00-2:00pm Eastern Sponsored by Homecare Homebase In mid-2019, the Department of Health and Human Services’ Office of the Inspector General (OIG) issued reports that raised considerable concerns in Congress, at the Centers for Medicare & Medicaid Services (CMS) and among hospice stakeholders. While the OIG’s findings indicated that a relatively […]

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OIG Warns of COVID-19 Fraud

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The U.S. Department of Health and Human Services’ Office of Inspector General is alerting the public about fraud schemes related to the novel coronavirus (COVID-19). Scammers are using telemarketing calls, text messages, social media platforms, and door-to-door visits to perpetrate COVID-19-related scams. Fraudsters are offering COVID-19 tests, HHS grants, and Medicare prescription cards in exchange […]

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OIG Adds 2 Home Health Items to Work Plan

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The Office of Inspector General (OIG) has announced two new items of interest to NAHC home health members. One is an audit of home health telehealth services during the COVID-19 public health emergency (PHE) and the second is a report on the challenges faced by home health agencies in responding to the PHE and the […]

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House Approves Hospice Survey Reforms to Increase Survey Frequency, Expand Remedies

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On December 8, as part of the year-end legislative push, the U.S. House of Representatives approved the Beneficiary Enrollment Notification and Eligibility Simplification Act of 2019 (BENES Act) to address negative findings by the Department of Health and Human Services’ Office of the Inspector General (OIG) regarding survey performance by Medicare-certified hospice providers. The BENES Act incorporates the […]

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OIG: Poor Oversight Led Medicare to Overpay for Hospital Inpatient Claims with Post-Acute-Care Transfers to Home Health

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A new report from the Office of Inspector General (OIG) has found that Medicare improperly paid most inpatient claims to the transfer policy when beneficiaries resumed homoe health services within three days of of discharge but the hospitals failed to code the inpatient claim properly and recommends the Centers for Medicare & Medicaid Services (CMS) […]

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Medicare Contractors Were Not Consistent In How They Reviewed Extrapolated Overpayments

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The Office of Inspector General (OIG) of the Department of Health and Human Services conducted an audit to determine whether the Centers for Medicare & Medicaid Services (CMS) ensured that MACs and QICs reviewed appealed extrapolated overpayments consistently and in a manner that conforms with existing CMS requirements. The OIG concluded that the MACs and […]

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