According to a recent OIG report, hospices billed inappropriately almost one-third of Medicare general inpatient care (GIP) stays in 2012, resulting in $268 million in inappropriate Medicare payments. The GIP level of care includes hospice inpatient unit, hospital, or SNF services for pain control or acute or chronic symptom management that cannot be managed in other settings, such as the beneficiary’s home. The OIG asserts that for 20% of GIP stays in 2012, the beneficiary did not need GIP at all, while for an additional 10% of GIP stays, the GIP level of care was only needed for a portion of the stay. Furthermore, in 1% of stays reviewed, there was no evidence that the beneficiary elected hospice care or was certified as having a terminal illness. Other OIG findings from the report include the following: hospices did not meet all care planning requirements for 85% of GIP stays; hospices did not provide enough nursing, physician, or medical social services in 9% of GIP stays; certain states, including Florida, Ohio, and Arizona, had higher proportions of inappropriate GIP stays; hospices were more likely to bill inappropriately for GIP provided in SNFs than other settings; for-profit hospices were more likely than other hospices to submit inappropriate bills for GIP; and Medicare Part D sometimes paid for drugs during GIP stays that should have been covered under the hospice daily rate. The OIG makes a series of recommendations intended to ensure that hospices provide the appropriate level of care and to protect the integrity of the Medicare hospice benefit. Specifically, the OIG recommends that CMS: (1) increase its oversight of hospice GIP claims and review Part D payments for drugs for hospice beneficiaries; (2) ensure that a physician is involved in the decision to use GIP; (3) conduct prepayment reviews for lengthy GIP stays; (4) increase surveyor efforts to ensure that hospices meet care planning requirements; (5) establish additional enforcement remedies for poor hospice performance; and (6) follow up on inappropriate GIP stays, inappropriate Part D payments, and poor-quality care identified by the OIG. CMS concurred with the OIG’s recommendations.  For additional information, see the full report, “Hospices Inappropriately Billed Medicare Over $250 Million for General Inpatient Care.”