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Hospice Office of the Inspector General Medicare

Troutman Pepper Locke

HHS Sets Its Sights on $50B in Cost Savings: Medicare Payments to Nonhospice Providers Potentially Under Fire

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In May 2025, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) published a review, titled “Potential Cost Savings HHS Programs – HHS Actions,” which provided some insight into the OIG’s...more

Husch Blackwell LLP

Hospice Insights Podcast - Hospice Audit Updates: David Beats Goliath

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Hospice audits can have profound financial implications, particularly when the auditors use statistical extrapolation to identify an overpayment amount. The use of extrapolation runs across auditor types, including UPICs and...more

Arnall Golden Gregory LLP

AGG Talks: Home Health & Hospice Podcast - Episode 10: Anti-Kickback Compliance for Hospice and Skilled Nursing Providers

In this episode, AGG Healthcare attorneys Bill Dombi and Jason Bring discuss recent OIG guidance on hospice and skilled nursing facility relationships, focusing on anti-kickback risks and fraud concerns. They cover key issues...more

King & Spalding

OIG Report Finds that the Medicare Program Improperly Paid Acute-Care Hospitals for Outpatient Services Provided to Hospice...

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On November 12, 2024, OIG published a report concluding that the Medicare program overpaid acute-care hospitals an estimated $190 million over five years for outpatient services provided to hospice enrollees....more

Morgan Lewis - Health Law Scan

Hospice General Inpatient Services (GIP): New OIG Audit Alert

The HHS Office of Inspector General (OIG) announced on June 15, 2023 that it plans to initiate a new audit of Medicare payments for hospice general inpatient (GIP) services, focused on hospice GIP services furnished to...more

Husch Blackwell LLP

Heed Caution: Takeaways From the OIG's Advance Care Planning Report

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The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) reported in November 2022 that many providers are not complying with Medicare’s billing rules for advance care planning services. In large...more

Morgan Lewis - Health Law Scan

OIG Hospice Audits of Provider Relief Fund Use Have Arrived

The HHS Office of Inspector General (OIG) has, for the last several years, been actively auditing hospices regarding their Medicare regulatory and billing compliance, with a national hospice audit in the works. Recently, OIG...more

Health Care Compliance Association (HCCA)

[Virtual Event] Healthcare Enforcement Compliance Conference - November 7th - 9th, 8:55 am - 3:30 pm CST

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us virtually at HCCA’s Annual Healthcare Enforcement Compliance...more

Husch Blackwell LLP

Hospice Audit Series: Beyond Part D, OIG Scrutinizes the Hospice Industry to the Tune of $6.6 Billion

Husch Blackwell LLP on

In a follow-up to its recent reports on billing outside the hospice benefit for drugs and durable medical equipment (DME), the Office of Inspector General’s (OIG) new data report identifies billions being billed to Medicare...more

King & Spalding

OIG Report Analyzes Payments in Excess of Hospice Per Diem Rate

King & Spalding on

Last week, OIG released a report analyzing trends in the last decade relating to Medicare payments for hospice beneficiaries outside of the hospice per diem. In the report, OIG notes that CMS has taken the position that...more

Morgan Lewis - Health Law Scan

OIG Planning Nationwide Audit of Hospice Eligibility – What You Should Know

The HHS Office of Inspector General (OIG) recently announced its Office of Audit Services plans to conduct a nationwide review of hospice eligibility, focusing on those Medicare hospice beneficiaries who haven't had an...more

Morgan Lewis - Health Law Scan

MA Audit: Hospices Unaware of Dual Eligibles Medicaid Filing Rule, Causing Potential Overpayments

The US Department of Health and Human Services, Office of Inspector General (OIG) recently transmitted a memorandum to the Center for Medicaid and CHIP Services detailing the findings of the Massachusetts state auditor's...more

Morgan Lewis - Health Law Scan

CMS Relaunches Hospice TPE Audits with Long-Stay General Inpatient Reviews

The Centers for Medicare and Medicaid Services (CMS) announced that it had restarted the Targeted Probe and Educate (TPE) audit process, effective September 1, 2021. More recently, the Medicare Administrative Contractors for...more

Morgan Lewis

Hospice: Consolidated Appropriations Act Revamps Medicare Survey and Certification Process

Morgan Lewis on

Modifications also include public disclosure of accreditation organization survey information and intermediate civil penalty remedies for noncompliance. The Consolidated Appropriations Act, 2021 (Pub. L. 116-260), signed into...more

Arnall Golden Gregory LLP

Hospice Payments Possibly Impacted by OIG Wage Index Recommendation

An August 2020 report by the U.S. Department of Health and Human Services Office of the Inspector General recommended that the U.S. Centers for Medicare & Medicaid Services (CMS) revamp its use of the hospital wage index to...more

Arnall Golden Gregory LLP

AGG Hospice Quarterly 2020

CMS Announces Hospice Capitation Rates for Medicare Advantage - The U.S. Centers for Medicare and Medicaid Services (CMS) recently released the capitation rates for hospice care through the value-based insurance design...more

Morgan Lewis - Health Law Scan

Recent Government Hospice Reports: Unfavorable Findings Continue

The government watchdog agencies continue to focus their attention on Medicare oversight of hospice providers, with two recent reports from the US Government Accountability Office (GAO) and the HHS Office of Inspector General...more

Baker Donelson

OIG Work Plan – October 2019 Update

Baker Donelson on

The OIG updates its Work Plan monthly to identify audits and evaluations that are underway or proposed by the OIG's Office of Audit Services and Office of Evaluation and Inspections. The October 2019 update identifies new...more

Bricker Graydon LLP

Recent OIG audit report on duplicate Medicare payments for drugs prescribed to hospice patients shows tension between OIG and CMS...

Bricker Graydon LLP on

On August 22, 2019, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a report following up to an audit that the OIG performed in 2012 indicating that Medicare Part D paid for...more

Sheppard Mullin Richter & Hampton LLP

CMS Finalizes 2020 Hospice Rule: Big Changes Coming

On August 6, 2019, CMS finalized its 2020 hospice rule, including adopting, without substantial modification, two controversial and material changes to the hospice benefit: Rebasing payment rates to shift about $500...more

Mintz - Health Care Viewpoints

OIG Reports Focus on Hospice Quality of Care

Earlier this month, the Office of Inspector General for the U.S. Department of Health and Human Services (OIG) released two reports regarding its concerns and recommendations related to quality of care at hospice facilities....more

Arnall Golden Gregory LLP

OIG Details Hospice Quality of Care Issues and Recommends Tougher Enforcement Measures

Earlier this month, the U.S. Department of Health and Human Services' Office of Inspector General (OIG) issued two companion reports that, together, called for increased regulatory scrutiny of hospices, greater transparency...more

Bricker Graydon LLP

OIG, DOJ put hospice providers under a microscope

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The Office of Inspector General’s (OIG) recent report, “Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity: An OIG Portfolio,” calls out a number of areas where the OIG identified room...more

Epstein Becker & Green

OIG Portfolio Highlights Hospice Fraud and Quality-of-Care Concerns

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On July 31, 2018, the Office of Inspector General (“OIG”) of the U.S. Department of Health and Human Services released a portfolio titled “Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program...more

Flaster Greenberg PC

It’s Important to Choose Where Hospice Is Provided

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It is understandable but unfortunate that family members frequently hesitate to broach the subject of end of life care. Instead of avoiding the subject, have a sensitive and frank discussion of hospice as a vehicle for...more

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