Questionable Billing for Hospice Physician Services
According to a recent OIG report, "Questionable Billing for Physician Services for Hospice Beneficiaries," Medicare made nearly $566,000 in questionable payments for Part B physician services provided to hospice beneficiaries in 2009 (i.e., payment was made to the physician through both Part A and Part B). Specifically, the OIG identified 9,272 questionable Part B claims for physician services provided to hospice beneficiaries in 2009, submitted by 3,116 physicians. In addition, 664 hospices were associated with Part B questionable claims. Six of the 10 physicians and 8 of the 10 hospices associated with the highest questionable Part B payments were in Florida. Although the OIG did not conclude that this problem is widespread, billing for physician services for hospice care is a potential program vulnerability given that Medicare may be billed under Part A and Part B. The OIG will refer the questionable claims to CMS for appropriate action.
