In its 2014 work plan, which was released on Jan. 31, the HHS Office of Inspector General (OIG) said it will begin to review the extent to which hospices serve Medicare beneficiaries who live in assisted living facilities to determine the length of stay, levels of care provided and common terminal illnesses. This will help CMS to meet the Affordable Care Act’s requirement to reform the hospice payment system and collect the data needed to do so, the work plan explains.
 
With regard to home health, the OIG will continue to review compliance with various aspects of the home health prospective payment system, including documentation required to support Medicare claims that home health agencies submit to determine whether they were paid in accordance with federal laws and regulations. A prior OIG report indicated that one in four agencies had “questionable billing,” the work plan says.
 
The OIG will also examine the extent to which home health agencies are complying with state requirements to conduct criminal background checks on job applicants and employees.