Medicare is getting ripped off by hospice providers.
A new report details ways in which the federal government's health care program for the elderly is routinely overpaying hospice providers for prescription drugs and inpatient care.
Medicare is paying for unnecessary inpatient care for roughly 30 percent of the hospice patients that it covers. In most of those cases, auditors found, the patient should have been receiving treatment at home, rather than in a hospice facility. And in another large chunk of the cases, the patient only needed a brief stay at a facility, but the hospice provider was nevertheless billing for long-term inpatient care.
The feds cough up $720 to providers for each day of inpatient hospice care, while they only pay $187 a day for home hospice care.
In the context of the $500 billion spent annually on Medicare, the $260 million of unnecessary hospice charges identified in the report is peanuts.
Rather, it is one of the many examples of medical providers delivering care that many experts say comes at a major expense, both to taxpayers and to the quality of life of patients.
Hospice providers have already been under scrutiny for routinely enrolling patients who, according to Medicare guidelines, should not qualify for end-of-life care. Medicare rules state that hospice care is intended only for those expected to die within six months, but in recent years a large percentage of hospice patients have received such care for much longer terms.
Medicare spends $9 billion annually on hospice patients who don't meet the program's qualifications, according to one recent study.
Another study found that Medicare providers often conduct costly cancer screenings on elderly patients, contrary to recommendations by medical authorities. A large percentage of patients over the age of 75 are being screened for breast cancer or prostate cancer, a phenomenon that experts increasingly say is counterproductive, since such diseases often progress slowly and false diagnoses often spur aggressive treatments that do little to extend the patient's life, but can make his or her remaining time extremely painful.
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