Hospices / Fraud Alerts / Nursing home arrangements with hospices

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article reviews an OIG Special Fraud Alert focused on hospice and nursing home business arrangements. It explains the general compliance concerns the agency identified, why these arrangements attract scrutiny, and the types of hospice-related referral and service arrangements that prompted the alert. The content is most relevant to hospice compliance, nursing facility administration, and healthcare fraud and abuse professionals.

Why This Topic Matters

Hospice and nursing home relationships can create fraud-and-abuse risk if compensation, referrals, or services are structured in ways that may be viewed as improper. Understanding the alert helps organizations recognize the compliance issues that OIG is highlighting and evaluate their arrangements more carefully.

Article Sections

  1. Nursing home arrangements with hospices

    Introduces the Special Fraud Alert and explains the general compliance concern involving hospice and nursing home relationships. It frames the kinds of arrangements the agency is cautioning against.

  2. Suspect arrangements encountered by OIG

    Summarizes the categories of hospice and nursing home dealings that drew OIG attention. The section addresses compensation, referral-related arrangements, and the provision of services or resources.

What You Will Learn

  • The compliance issues OIG associates with certain hospice and nursing home arrangements
  • Why exclusive referral relationships can draw fraud-and-abuse scrutiny
  • What broad categories of arrangements were highlighted in the Special Fraud Alert
  • How the alert relates to hospice, nursing home, and Medicare/Medicaid billing relationships

Who Should Read This

  • Hospice compliance staff
  • Nursing home administrators
  • Healthcare attorneys
  • Medical coders and auditors
  • Fraud and abuse compliance professionals

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