Recent Investigations and Enforcement Trends in Hospice Care
Overview:
During 2012 alone, the Federal Government won or negotiated over $3.0 billion in health care fraud judgments. Reimbursement for hospice services has received special attention based on increased enforcement and reports issued by the Medicare Payment Advisory Committee regarding increased lengths of stay for hospice residents over the past several years. The OIG and DOJ have also frequently included hospice as an area of enforcement in their Work Plans and Annual Reports. Recent enforcement actions include those against Hospice of Arizona ($12 million), Ensign Group ($48 million), Hernando-Pasco Hospice ($1 million), and Hospice Care of Kansas ($6.1 million).
From 2005 to 2011 spending on hospice care for nursing home residents increased by 70%. The Federal government has increasingly targeted hospice care as an area of enforcement, and collected large sums in fines and penalties for false claims. It is clear that certain types of billing activities, marketing practices and relationships between nursing facilities and hospice care providers are the subject of intense scrutiny by the government. My session will highlight certain behaviors that have been targeted for enforcement and provide practical ideas about how to avoid becoming the next entity to potentially pay millions to the Federal government.
Why should you attend:
- Education of hospice care providers (and those that contract with hospice care providers, such as hospitals and skilled nursing facilities) regarding areas highlighted by the Federal government for investigation and enforcement
- Discuss certain behaviors that could lead to an investigation or enforcement action by the Federal government in order to help hospice care providers avoid being the target of enforcement
- Share recent enforcement actions, investigations and lawsuits brought against hospice providers
Areas Covered in the Session:
- Overview of Regulatory Requirements for Hospice
- Hospice Enforcement Trends
- Investigatory and Enforcement Landscape
- Enforcement and the Affordable Care Act
- Questions and Answers
Who Will Benefit:
- CEOs/CFOs/COOs of Hospice Care Providers
- Continuing Care Retirement Communities
- Skilled Nursing Facilities
- Home Health Agencies
- General Counsel
- Compliance Officers/Compliance Office Personnel
- Internal Auditors
- Nursing Executives