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Excerpt
Aren’t all our motives altruistic and don’t we always act in accordance with ethical standards and good business practices?
Good intentions and a desire to do what is right for those we serve actually have little to do with corporate compliance and abuse of government monies. As providers of a government subsidized healthcare program, we are mandated to practice in accordance with the related laws and regulations. The Hospice Medicare Benefit was a boom for hospice and has allowed us financial stability and continued viability. However, along with the acceptance of government monies comes the accountability for the handling of such funds and an agreement to practice in accordance with the Medicare Conditions of Participation.
As taxpayers, we should all be outraged regarding abuse of government funds. The Office of Inspector General has uncovered numerous serious infractions. Providers have billed for services and equipment never provided. Care plans have been “created” and certified by healthcare professionals who never saw a patient. Double billing and over billing occur all too frequently. It has been estimated that 10% or more of all federal healthcare expenditures (which total approximately $1 trillion) are misspent. Unfortunately, some hospice providers have been found guilty of fraud and abuse.
Investigators have found hospice programs that offer minimal services (especially to patients residing in nursing facilities), some that have answering services to take messages during on-call hours without providing visits or services during these hours, those who sign on chronic long-term patients without clinical evidence of the terminal prognosis, and others that fail to provide professional management and oversight of the hospice plan of care.
