CMS Proposes New Hospice Scoring System Designed to Target Fraudulent Billing

On April 2, CMS proposed a new rule that outlines a scoring system for hospice providers aimed at detecting potential quality of care and compliance concerns, in addition to inappropriate utilization. CMS is taking a data-driven approach to identify and address fraudulent hospice activities at hospice facilities, which has also included unannounced hospice site visits and the removal of hundreds of hospice providers engaged in inappropriate activity. Hospice facilities that receive high scores could be subject to additional review to evaluate potential program integrity or compliance issues. For additional information on CMS’s recent crackdown on hospice services, see HLB’s article published in Bloomberg Law.