LeadingAge and five other national hospice associations met with the Office of Inspector General (OIG) to discuss recent audit activities and encourage to respond to the recent in the New Yorker about hospice fraud and abuse. Mollie Gurian, LeadingAge’s VP of Home-based and HCBS Policy, drove home the groups collective concerns about the current audit process being focused on chart review, when fraud indicators such as high percentage of live discharges was a better indicator of potentially fraudulent activity. She said in the average hospice you will have long length of stay outliers, but the majority of hospice patients have very short lengths of stay and emphasized that OIG’s time would be better served by looking at agencies with a high number of outliers. OIG staff were grateful for the feedback and interested in learning more from the sector in writing on how oversight of the program could be improved. They also noted that hospice is of interest to the organization as it is a critically important services and protecting the integrity of the benefit and improving quality of the care were important. OIG is always looking at solutions that will have the greatest impact but are practical and can be implemented by CMS in a way that makes sense from the sector perspective.
