Alleged $250 million overbilling charges in hospices disputed , experts say

A recent HHS Office of Inspector General report calling out hospices for billing $250 million inappropriately in 2012 doesn't tell the whole story, an attorney said this week.

The report covered 1.5% of the hospice expenditures in 2012, Kathleen McDermott, an attorney at Morgan, Lewis & Bockius LLP, told Bloomberg BNA. Her firm released an analysis this week in which it noted the OIG said hospices were more likely to inappropriately bill for general inpatient care when inpatient care was given in a skilled nursing facility.

Another finding: The OIG said 15% of inappropriate GIP stays were because hospices used that level of care due to beneficiary caregiver problems. The OIG said those cases should have been billed as respite care, at a lower amount.

Many of the OIG's recommendations, such as improving program requirements, have been put into place for hospices since 2012, McDermott noted. Still, the firm advised “many hospices should assess anew their internal controls related to their use of the GIP level of care, with additional government scrutiny likely in the future for this essential hospice service.”

In unrelated hospice news, an Indiana federal court dismissed a provider's claims of discriminatory site survey practices this week. The court referred the provider, Home Care Providers Inc., to the Medicare administrative appeals process. The owner, Dev A. Brar, said state administrators discriminated against him based on race and nationality via “racially tinged” remarks left on voicemail.