by Ben Vernia | September 27th, 2010
In a report issued on September 22, the Inspector General of HHS (OIG-HHS) reviewed Medicare claims for physician services provided to hospice patients. Depending on the doctor’s relationship to the hospice, these services could be billed by the physician (under Medicare Part B), or by the hospice (under Part A). What concerned OIG-HHS was the possibility that a claim for the same service might be submitted and reimbursed under both programs.
Despite over 1 million Medicare beneficiaries receiving over $11 billion of hospice services, the OIG found only $566,000 in duplicate claims (1/3 of which, unsurprisingly, came from Florida). The report recommended that notwithstanding this low rate, CMS should continue to watch such claims, which present a potential “program vulnerability.”
