News & Analysis as of

Office of the Inspector General Hospice

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

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - July 21st - 24th, Nashville, TN

Grounded in the OIG’s General Compliance Program Guidance and DOJ’s Evaluation of Corporate Compliance Programs, our immersive, three-and-a-half-day, classroom-style Healthcare Basic Compliance Academy equips compliance...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

Arnall Golden Gregory LLP

AGG Talks: Home Health & Hospice Podcast - Episode 7: OIG Report Reveals Gaps in Hospice PRF Compliance: What Providers Need to...

In this episode, AGG Post-Acute & Long-Term Care co-chair Jason Bring is joined by AGG Healthcare partner Alex Foster to discuss a recent OIG report highlighting Provider Relief Fund compliance issues within the hospice...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

Husch Blackwell LLP

Hospice Insights Podcast - A Refresh: What’s New in the New OIG General Compliance Program Guidance

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Compliance gets a dust off with the new General Compliance Program Guidance released by the federal Office of the Inspector General (OIG) in November 2023. While there is a lot to digest, Husch Blackwell’s Josi Wergin and...more

Husch Blackwell LLP

OMG. . .The OIG is at it Again

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Five years ago, the U.S. Department of Health and Human Services Office of Inspector General (OIG) initiated audits of 13 hospices and published its findings in 13 separate reports. It appears that the OIG is at it again, as...more

King & Spalding

OIG Releases Compliance Program Guidance Applicable to All Providers and Suppliers

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On November 6, 2023, OIG released new General Compliance Program Guidance (General CPG). The General CPG applies to all individuals and entities involved in the healthcare industry. The release of the General CPG was not...more

Arnall Golden Gregory LLP

Home Health & Hospice Quarterly - Q2

AGG’s Home Health & Hospice team publishes a quarterly newsletter covering legal and regulatory topics specific to the home and community-based healthcare industry. The fields of end-of-life and home healthcare present...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

Arnall Golden Gregory LLP

OIG Developing Updated Compliance Guidance for Hospices and Other Providers

Over the last three decades, the OIG has developed a series of voluntary compliance program guidance documents (“CPGs”) directed at various segments of the healthcare industry, such as hospitals, nursing homes, and hospices....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

Husch Blackwell LLP

UPIC Report Card: The OIG’s Evaluation of the UPICs Provides Insight Into the Future of Hospice Audits

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The Department of Health and Human Services Office of the Inspector General (OIG) recently released a report detailing its evaluation of CMS’s primary fraud, abuse and waste investigators—the Unified Program Integrity...more

Arnall Golden Gregory LLP

Hospices Audited for Provider Relief Fund Payments

After more than two years since the initial Provider Relief Fund (“Fund”) disbursement, hospices are beginning to see audits of their Fund expenditures by the U.S. Department of Health & Human Services (“HHS”) Office of the...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

Husch Blackwell LLP

COVID-19 Hospice How-To Series | Pulling the Strings: New OIG Audits Scrutinize How Hospices Used Provider Relief Funds

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For the last two-and-a-half years, hospices and other providers have been using billions in Provider Relief Fund (PRF) payments to prepare for, respond to and recover from the COVID-19 pandemic. The Office of Inspector...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

Beyond Hospice: And They’re Off! The OIG’s Nationwide Review of Hospice Eligibility Has Begun

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In a prior podcast, we alerted you to the Office of Inspector General’s (OIG) nationwide review of hospice beneficiary eligibility. The OIG has begun sending out requests for records to hospices across the country. In this...more

Husch Blackwell LLP

Beyond Hospice: The OIG Renews Its Scrutiny of Home Health Agencies

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As many hospices continue to diversify into new business lines, staying abreast of enforcement trends outside of hospice is more important than ever. Home health in particular, is receiving significant government scrutiny. In...more

Husch Blackwell LLP

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

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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

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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

Husch Blackwell LLP

The OIG's Impending Review of Nationwide Hospice Eligibility Demands a Robust Response From Hospices

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The Office of Inspector General (OIG) recently announced that its 2022 work plan for hospices will include a nationwide review of hospice beneficiary eligibility. In this episode, Husch Blackwell’s Meg Pekarske and Bryan...more

Maynard Nexsen

SMRC Targets for 2022: After Heavy Focus on Hospice, the SMRC Moves On to Home Health and Other Projects

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The Supplemental Medical Review Contractor (“SMRC”) is a Centers for Medicare and Medicaid Services (“CMS”) contractor authorized to conduct nationwide medical reviews (Medicare Part A, Part B, and DME). As many in the...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

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