Payment fraud schemes are a rising problem, as hospices purposely bill patients inappropriately. Payment currently depends on level of care, not the amount of services provided, and some hospices are taking advantage of the system.
Hospices are cashing in on inaccurate billing, patient referral kickbacks, overcharging and billing for higher-level, more expensive care than is truly needed. The report found that hospices often charged patients for general inpatient care, the second most expensive level of hospice care, when the patients only receive home care, making as much as $521 more per day for the upcharge, the report estimated.
The National Hospice and Palliative Care Organization was guarded in its statements after the HHS Inspector General report. Its president and CEO Edo Banach said in a statement that incidents of deliberate fraud and abuse in the hospice field are “rare and isolated” but he added that they are “indefensible.”
It attempted to shift the conversation to regulation in its statement. Banach said the rare incidents of deliberate fraud and abuse should be viewed separately from unintentional documentation or mathematical errors in “an extraordinarily burdensome and complicated regulatory environment.”
It stated that it wants to work with the federal government to “ease the governmental red tape in order to encourage honest and law-abiding hospice providers while protecting the public from unacceptable intentional abuse. … focus government efforts on truly abhorrent providers and spare compliant programs from needless and duplicative investigation.”
Source : CNBC