The $8.3 Million Dollar Audit: How to Prevent Overpayments with Hospice Benefits

The OIG’s Annual Workplan for 2022 includes the continuous auditing and monitoring of items and services provided to hospice beneficiaries during a hospice period of care. So provider organizations must conduct routine audits to ensure that all reimbursements received are for items and services that treat conditions related to the beneficiary’s terminal illness and related conditions.

Recently the OIG audited Tidewell Hospice, Inc., and estimated at least $8.3 million in Medicare reimbursement for hospice services that were not compliant.

“Tidewell claimed Medicare reimbursement for hospice services for which the clinical record did not support the beneficiary's terminal illness prognosis or the level of care claimed and for services that were not eligible for Medicare reimbursement. These improper payments occurred because Tidewell’s policies and procedures for ensuring that claims for hospice services met Medicare requirements were not always effective. On the basis of our sample results, we estimated that Tidewell received at least $8.3 million in Medicare reimbursement for hospice services that did not comply with Medicare requirements.”
–OIG.HHS.GOV

$8.3 million dollars in Medicare reimbursements. That’s no small amount. And chances are it’s entirely possible that it could have been prevented.

Tune into our free webinar, “Hospice Benefits and How to Prevent Overpayments to Your Organization,” with one of our all-time favorite auditing experts, La Tanya McNair, to prevent overpayments to your organization.

This in-depth webinar will include the following hot medical auditing topics:

• • The OIG’s 2022 Work Plan
  • Hospice Benefits
  • Hospice Benefits Period
  • Re-Certification Requirements
  • Documentation Requirements
  • Inconsistent Documentation
  • Covered Items and Services
  • Non-Covered Services
  • DME Checks and Balances
  • Facility Notification of Election
  • Billing Modifiers
  • Q&A Options

The best way to prevent overpayments with hospice benefits is to stay informed, identify risks, and have a plan. This webinar will cover all of those bases so you can remain ahead of the curve and your organization can stay compliant.