The new hospice compliance plan: defining and addressing risk areas.
The Department of Health and Human Services' (HHS) Office of the Inspector General (OIG), has advised hospices and other health care providers to formulate effective controls to ensure compliance with federal and state statutes, rules, and regulations, and private-payor health care program requirements. The recently released guidelines provide a blueprint for developing such programs. This is the first of four installments that focus specifically on the 28 risk areas identified in the guidance and offer strategies for incorporating them in a hospice compliance program. The authors have organized the 28 risk areas under 9 topic domains to simplify the task of tackling the guidance. This article covers the first two areas: Admission/Certification/Recertification and Billing.
Jones
D H
DH
Ethos Consulting Group, L.L.C. in Moorestown, New Jersey, USA. djones@ethosconsult.com
Woods
K
K
D002568:Certification; D005161:Facility Regulation and Control; D005607:Fraud / Q000331:legislation & jurisprudence / Q000517:prevention & control*; D019983:Guideline Adherence; D006738:Hospices / Q000191:economics* / Q000592:standards; D010343:Patient Admission; D010350:Patient Credit and Collection; D012308:Risk Management / Q000592:standards*; D014481:United States; D014483:United States Dept. of Health and Human Services