Hospice groups billed Medicare about $268 million for general inpatient care that was never given or not necessary during 2012, according to a new report by the Health and Human Services’ Office of the Inspector General.
The study, released Thursday, looked at a random sampling of short-term inpatient care records and concluded that one-third of the stays were inappropriately billed.
“Such misuse has human costs for this vulnerable population as well as financial costs for Medicare,” Inspector General Daniel R. Levinson wrote.
Hospice is meant to help the terminally ill in the comfort of their home or a private residence. General inpatient care is the second most costly type of hospice care because it requires daily check-ins by medical personnel, if not live-in assistance.
The inspector general said for-profit hospice providers were more likely than others to inappropriately bill the government. Levinson also determined that Medicare paid for drugs twice because the prescriptions were billed through Part D as well as under the daily payment rate.
Levinson called on the federal Centers for Medicare and Medicaid Services to take six steps to correct the illegal behavior, including increased oversight of the claims and Part D payments for drugs, ensuring doctors approve the decision to use hospice care, and the development of follow-up procedures for inappropriate general inpatient care stays.
