HHS Inspector General’s Report Finds Flaws And Fraud In U.S. Hospice Care

Good hospice care at the end of life can be a godsend to patients and their families, all agree, whether the care comes at home, or at an inpatient facility like this AIDS hospice. Still, oversight of the industry is important, federal investigators say.

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We all hope for a little peace at the end of life, for ourselves and for our loved ones. Hospice services can play a big role, relieving pain and providing spiritual and emotional support. But a federal report published Tuesday synthesized patient and Medicare payment data going back to 2005 and found that, while patients generally can count on hospice to relieve their suffering, some hospice providers are bilking Medicare and neglecting patients.

The report calls for the Centers for Medicare and Medicaid Services, which is a key player in the funding of hospice services, to increase its level of scrutiny to improve the detection of these problems.

Hospice services are an increasingly popular Medicare benefit. In 2016, Medicare paid hospice providers $16.7 billion. A decade earlier, it was $9.2 billion. And, unlike many other health care providers, hospices aren’t paid per service rendered. They’re paid per patient, per day, “regardless of the number of services they provide and regardless of the quality of care they provide,” says Nancy Harrison, a deputy regional inspector general in the U.S. Department of Health and Human Services and the lead author of the report.