CMS: Nearly 400 Hospices Considered for ‘Administrative Action’ as Program Integrity Efforts Heat Up

Hospice News | By Jim Parker

The U.S. Centers for Medicare & Medicaid Services (CMS) is considering administrative action against 400 hospices, which could include revocation of their Medicare certification.

The agency has been mobilizing against hospice fraud this year. In addition to new regulations and updated survey processes, CMS has been conducting unannounced onsite visits. To date, CMS personnel have appeared at 7,000 locations, with plans to visit every hospice site in the country.

Two CMS officials outlined the effort in a blog post emailed to Hospice News — Dara Corrigan, CMS deputy administrator and director of the Center for Program Integrity, and Dr. Dora Hughes, acting director of the agency’s Center for Clinical Standards and Quality (CCSQ) and acting CMS chief medical officer.

“CMS revisited and revitalized our hospice program integrity strategy, focusing on identifying bad actors and addressing fraudulent activity to minimize impacts to beneficiaries in the Medicare program,” Corrigan and Hughes wrote. “As part of this strategy, CMS embarked on a nationwide hospice site visit project, making unannounced site visits to every Medicare-enrolled hospice. Our goal was to protect patients and their families from engaging with fraudulent actors by making sure that each hospice is operational at the address listed on their enrollment form.”

The agency is working to curb the impact of a rash of new providers that have emerged so far in four states: California, Arizona, Texas and Nevada…

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