OIG Alert: Medicare Services during Hospice Election

CMS’ Office of Inspector General (OIG) is looking at patients who receive hospice and also receive other Medicare services.  The OIG announced as part of the continuing work to ensure proper billing procedures, patients who have elected Hospice care should not be receiving any other form of Medicare service at the same time.

The OIG is specifically looking at Medicare billing and services provided to patients that are in conflict with a patient’s terminal illness diagnosis and status. Some payments for services are allowed for DME, prosthetics, orthotics, supplies, physician services and outpatient services.  However, some inpatient treatments are not being properly paid for by the hospice and are instead being billed directly to Medicare.

In effect, OIG is looking at duplicate billing during an election period.  Medicare should only be paying for one type of inpatient care and in some instances, Medicare is paying for two types of care.