Medicare Spent $1.8 Billion for Improperly Filed Nursing Home Care

The OIG report also discovered that not-for-profit hospices were significantly more likely to not comply with Medicare hospice claims requirements than for-profit hospices. "Specifically, 89 percent of claims from not-for-profit hospices did not meet Medicare requirements, compared to 74 percent of claims from for-profit hospices."

The OIG issued three recommendations:

• CMS should educate hospices about the coverage requirements "and their importance in ensuring quality of care…Our findings raise questions about whether hospices…are furnishing needed services to beneficiaries at an especially vulnerable time in their lives."
• CMS should provide tools and guidance to hospices to help them meet coverage requirements.
• CMS should strengthen its monitoring practices regarding hospice claims, including conducting more frequent certification surveys of hospices as a way to enforce those requirements.