The Department of Health and Human Services Office of the Inspector General issued the final two reports in a series of four, which reviewed the hospice benefit for residents of nursing facilities. The report indicated that 82% of the 470 claims that were part of the study did not meet at least one Medicare coverage requirement for hospice services. Among the OIG's recommendations were increased hospice provider education, tools fostering better compliance, and strengthened monitoring of practices, such as medical review and additional surveys.
The study, using a sample of 470 claim forms from 2006, highlighted technical compliance issues with the medical record that included forms that did not meet election requirements (33%), issues relating to plan of care requirements (63%), and hospices providing fewer services than outlined in the beneficiaries' plans of care (31%). Despite Medicare requirements not being met, the National Hospice and Palliative Care Organization (NHPCO), which gathers data on the quality of hospice care from bereaved family members, indicated slightly over two thirds of 30,000 surveyed families have rated the quality of hospice care provided in nursing homes as excellent. NHPCO has voiced strong support of the OIG’s recommendations. Source: Long-Term Living Magazine