Hospice agencies are being held to the fire by auditors recently due to the return to regular surveys that were on hold during the start of the pandemic and recent attention from OIG.
The most common reason for denial of Hospice General Inpatient Care (GIP) under a recent review was “Hospice General Inpatient Reduction — Services not reasonable and necessary.”
Hospice agencies should ensure education surrounding the relevance of medications to control pain, anxiety, agitation and other symptoms that impact patients’ quality of life.
Hospices should consider refreshing their volunteer programs with new recruitment efforts and personal protective equipment (PPE) training as CMS has started to reverse its pandemic waivers in other health care segments.
Hospice agencies have long advocated for reimbursement for remote patient monitoring (RPM), and some are now finding that offering palliative care support for other health care providers may present an avenue for reimbursement for such services.
CMS has issued new guidance around transfers from one hospice to another that prevents a gap in services, even if one day, to be considered a transfer.
The OIG is eyeing patient eligibility in hospices as the focus of an upcoming review.
Hospice providers need to refresh survey protocols and update staff on the new rules around surveyor practices and the consequences for providers out of compliance.
CMS recently responded to questions about calculating and reporting claims-based measures as part of the Hospice Quality Reporting Program.
There has been a gradual shift in the top reported principal diagnoses used for hospice care in recent years, and industry experts say CMS may be looking into this shift (involving some diagnoses with longer lengths of stay) as a sign of misuse of this service.


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