The HHS Office of Inspector General (OIG) has advised a hospital-based hospice it won’t challenge a plan by the hospice to coordinate free, non-skilled services for beneficiaries who may require Medicare hospice services in the near future.
 
The benefiting patients don’t qualify for hospice services because they are projected to have more than six months to live or because they don’t wish to give up curative treatment.
 
In an advisory letter released Nov. 9, the OIG says the arrangement raises anti-kickback issues because the patients it benefits may require Medicare-paid hospice services in the near future. In some cases, the volunteers would relieve the patient of costs the patient “might have incurred to engage a person or entity to provide similar services to those that would be offered under the proposed arrangement (such as doing errands, driving to appointments, etc.),” the OIG letter notes.
 
Thus, the central issue is whether the free services offered to potential patients would be likely to influence the patients to select the hospice as their provider of hospice services in the future, the letter indicates. As is customary with advisory opinions, the copy of the letter released by the OIG omits the name of the hospice in question.  
 
The OIG believes the proposed arrangement could influence the patients to select the hospice and “could potentially generate prohibited remuneration under the anti-kickback statute if the requisite intent is to induce or reward [hospice] referrals,” its letter states.
 
Nevertheless the non-skilled services provided under the proposed program “would be unlikely to influence patients” to choose the hospice’s hospital parent for medical care, the OIG concludes.
 
And while patients ultimately could select the hospice itself for hospice care, the program calls for informing patients of all the hospices serving their area, the OIG notes.