The US Department of Health and Human Services Office of Inspector General (OIG) published two reports identifying significant vulnerabilities in the Medicare hospice benefit that are harming beneficiaries.

The report analyzed auditing data from 2012 to 2016, representing almost all hospice facilities that provided care to Medicare beneficiaries. Over 80% had at least one deficiency (i.e., poor care planning, mismanagement of aid services). OIG recommends that the Centers for Medicare and Medicaid Services (CMS) provide more oversight of poor performing hospice facilities and educate providers on the most common deficiencies. The full report, “Hospice Deficiencies Pose Risks to Medicare Beneficiaries,” can be found here.

The second report identified episodes of harm to beneficiaries, how CMS could have prevented them, and vulnerabilities in beneficiary protections. OIG recommends that CMS seek authority to impose additional remedies for poor performance. The full report, “Safeguards Must be Strengthened to Protect Medicare Hospice Beneficiaries From Harm,” can be found here.

For more information, visit the McDermottPlus Payment Innovation Resource Center or contact Sheila Madhani at +1 202 204 1459 or smadhani@mcdermottplus.com.