The U.S. Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Justice (DOJ) are ramping up investigations into hospice fraud amid rising program integrity concerns in the space.
Unscrupulous operators have increasingly targeted vulnerable aging populations, said CMS Administrator Dr. Mehmet Oz during a recent press conference. The trend has resulted in several billions of health care dollars being fraudulently misspent, he stated.
Efforts to safeguard patients and their families have increased, with CMS and DOJ recently collaborating to address program integrity issues, particularly those occurring in certain geographic areas.
“Money is being sucked out of the system by these fraudsters,” Oz told CBS News at the conference. “But these fraudsters are calling people who aren’t going to die.”
Program integrity concerns have heated up in the hospice space in recent years. Fraudulent operators’ marketing strategies have included the use of illegal or unethical tactics, such as enrolling Medicare beneficiaries in hospice care without their knowledge or without providing services.
Additionally, unscrupulous operators have received federal funding through illegitimate business practices. Swarms of new operators have entered California, Arizona, Nevada and Texas, making these four states identified by federal watchdogs as hotspots for hospice fraud.
