Since 1995, the Department of Health and Human Services’ Office of the Inspector General has published warnings and reports outlining the misuse of the hospice benefit. Last year, it listed hospice fraud as the government’s top area for criminal recoveries, after the pharmaceutical and home health sectors. “It’s an open secret that hospice is one of the poster children for fraud and abuse in Medicare,” said David Grabowski, a health policy professor at Harvard who serves on MedPac, the federal advisory panel on Medicare spending.
Some hospices boost profits by signing people up regardless of whether they are dying. Marketers present the program as free home health care or steal personal information to enroll “phantom patients.” Others target assisted living facilities and nursing home residents whose life expectancy exceeds six months.
This guide can help you research your hospice provider and spot common signs of hospice fraud. It is adapted from the Senior Medicare Patrol National Resource Center, a grantee of the Administration for Community Living at HHS, that assists Medicare beneficiaries, families and their caregivers to prevent, detect and report health care fraud, errors and abuse.
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