decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Hospice Model Compliance Plan / Hospice Model Compliance Plan - Overview
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Article Overview
This article summarizes the Office of Inspector General’s model compliance plan for hospices and places it in the context of OIG’s broader compliance-program framework. It is aimed at hospice providers, compliance staff, and related organizations that need a high-level understanding of hospice-specific risk areas, eligibility and care-planning topics, service delivery considerations, and general compliance program elements. The piece helps readers understand the scope of the hospice model plan without replacing the full guidance.
Why This Topic Matters
Hospice organizations operate in a highly regulated environment, and this overview identifies the main compliance topics they should expect in OIG guidance. It also situates hospice-specific issues within the standard compliance-program structure used across health care settings.
Article Sections
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Essentials of OIG's hospice model compliance plan
Introduces the hospice-specific model compliance plan and the general purpose of the guidance for hospice organizations and their affiliates.
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Using OIG's hospice model compliance program
Covers how the hospice model compliance framework is intended to be applied within a provider’s internal compliance efforts.
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Risk areas
Summarizes the hospice-related compliance risk topics addressed in the plan.
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Eligibility requirements
Addresses the eligibility-focused content included in the hospice plan, including related patient qualification themes.
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Terminal illness as an eligibility requirement
Focuses on the article’s discussion of terminal-illness-related eligibility considerations within hospice guidance.
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Plan of care
Covers plan-of-care topics presented as part of hospice compliance guidance.
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Utilization of hospice services
Discusses hospice service use as a compliance topic under the model plan.
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Levels of hospice care
Reviews the hospice care-level subject area identified in the overview.
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Services provided to patients who reside in nursing homes
Addresses hospice-related service delivery considerations for patients living in nursing facilities.
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The elements that are common to all OIG's model compliance plans
Outlines the shared compliance-program framework used across OIG model compliance plans, including organizational, training, communication, response, and enforcement components.
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General compliance tips and tools
Concludes with general compliance resources and practical support topics relevant to implementation and oversight.
What You Will Learn
- The purpose and scope of the OIG hospice model compliance plan
- Which hospice-specific compliance topics are highlighted in the overview
- How the hospice plan fits into OIG’s common model compliance framework
- What general compliance-program elements are emphasized for health care organizations
Who Should Read This
- Hospice providers
- Compliance officers
- Health care administrators
- Billing and compliance staff
- Subcontractors and agents supporting hospice operations
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