Hospice claims in nursing facilities found noncompliant, OIG - 09/28/09

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Eighty-two percent of hospice claims for beneficiaries in nursing facilities in 2006 did not meet at least one Medicare coverage requirement, according to the Office of Inspector General (OIG). In 2006, Medicare paid approximately $1.8 billion for these claims. Eighty-one percent of the claims did not meet at least one Medicare coverage requirement relating to election statements, plans of care, services or certifications of terminal illness, and an additional one percent of the claims were undocumented (i.e., the hospices did not submit any records to support the claims, as required).
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