OIG: Poor Oversight Led Medicare to Overpay for Hospital Inpatient Claims with Post-Acute-Care Transfers to Home Health

A new report from the Office of Inspector General (OIG) has found that Medicare improperly paid most inpatient claims to the transfer policy when beneficiaries resumed homoe health services within three days of of discharge but the hospitals failed to code the inpatient claim properly and recommends the Centers for Medicare & Medicaid Services (CMS)…

Medicare Contractors Were Not Consistent In How They Reviewed Extrapolated Overpayments

The Office of Inspector General (OIG) of the Department of Health and Human Services conducted an audit to determine whether the Centers for Medicare & Medicaid Services (CMS) ensured that MACs and QICs reviewed appealed extrapolated overpayments consistently and in a manner that conforms with existing CMS requirements. The OIG concluded that the MACs and…

Enhancing RN Supervision of Hospice Aide Services

The Centers for Medicare & Medicaid Services (CMS) recently released an MLN Fact Sheet, Enhancing RN Supervision of Hospice Aide Services. This fact sheet contains information about frequency and documentation requirements of registered nurses’ (RN) supervisory visits. Learn how often RNs should visit patients in their homes to assess hospice aide’s quality of care and…

UPDATED: OIG COVID-19 Resources and FAQs

The Department of Health & Human Services (HHS) Office of the Inspector General (OIG) has a COVID-19 Portal covering various COVID-19 topics. Among them is a set of FAQs that is updated periodically. There are no home health or hospice specific FAQs currently posted; however, there are FAQs on topics that may be of interest…

OIG: CMS Could Save Money Reviewing Home Health Claims With Visits Slightly Above LUPA

The Centers for Medicare & Medicaid Services (CMS) could have saved $192 million by targeting home health claims for review with visits slightly above the threshold that triggers a higher Medicare payment, according to a new report from the Office of Inspector General (OIG) of the Department of Health & Human Services. Home health agencies…

Office of Inspector General Adds Home Health Work Plan Item

The Office of the Inspector General (OIG) has added a new item, Analysis of New Rural Add-On Payment Methodology, to its Work Plan, which details various projects, including OIG audits and evaluations that are underway or planned to be addressed during the fiscal year and beyond, by OIG’s Office of Audit Services and Office of Evaluation…

Important COVID-19 Updates for Providers from the OIG

The Office of the Inspector General (OIG) has updated COVID-19 information related to Corporate Integrity Agreement (CIA) deadlines, OIG review deadlines and OIG enforcement activity. The OIG is trying to minimize burdens on providers and be flexible where possible.  It is coordinating closely with Health & Human Services (HHS), the Centers for Medicare & Medicaid…

CMS Revises Safeguards for Medicare Patients in Hospice Care Fact Sheet

NAHC advocacy is a win for hospice As reported at the beginning of February, the Centers for Medicare & Medicaid Services (CMS) posted a MLN Hospice Fact Sheet, Safeguards for Medicare Patients in Hospice Care, and NAHC communicated with CMS regarding our concerns about some of the fact sheet’s contents. Specifically, a reference to the…

Key Congressional Leaders Develop Legislation to Address OIG Hospice Survey Concerns

NAHC is working with Congress on legislatoin to support hospice, address concerns The reports targeting hospice survey deficiencies and quality of care by the Department of Health & Human Services’ Office of the Inspector General (OIG) last summer have generated considerable activity in Congress, federal agencies, and among hospice stakeholders. While Senate legislation was introduced…

CMS Releases Safeguards for Medicare Patients in Hospice Care

The Centers for Medicare & Medicaid Services (CMS) recently posted a MLN Hospice Fact Sheet, Safeguards for Medicare Patients in Hospice Care, in response to two reports on hospice care by the Health and Human Services (HHS) Office of the Inspector General (OIG). (See previous coverage of these reports here and here.) The fact sheet…