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Date Issued
Submitting OIG
Department of Health & Human Services OIG
Other Participating OIGs
Department of Health & Human Services OIG
Agencies Reviewed/Investigated
Department of Health & Human Services
Report Number
A-09-18-03024
Report Description

The Medicare hospice benefit allows providers to claim Medicare reimbursement for hospice services provided to individuals with a life expectancy of 6 months or less who have elected hospice care. Previous OIG audits and evaluations found that Medicare inappropriately paid for hospice services that did not meet certain Medicare requirements.

Report Type
Audit
Number of Recommendations
3
Questioned Costs
$11,278,891
Funds for Better Use
$0

Open Recommendations

This report has 3 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
270905 No $8,992,578 $0

We recommend that Partners In Care, Inc. refund to the Federal Government the portion of the estimated $11,278,891 for hospiceservices that did not comply with Medicare requirements and that are within the 4-yearreopening period.

270906 No $6,770 $0

We recommend that Partners In Care, Inc. based upon the results of this audit, exercise reasonable diligence to identify, report, and return any overpayments in accordance with the 60-day rule and identify any of those returned overpayments as having been made in accordance with this recommendation.

270907 No $0 $0

We recommend that Partners In Care, Inc. strengthen its policies and procedures to ensure that hospice services comply with Medicare requirements.

Department of Health & Human Services OIG

United States