decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Hospices / Hospices - Overview
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Article Overview
This article explains the general framework for hospice services, including how Medicare payment is handled and how related billing channels differ depending on the provider relationship and setting. It also outlines key federal fraud and abuse laws and CMS manual guidance that are relevant to hospice organizations and physicians. The content is useful for coders, billers, compliance staff, and hospice administrators who need a high-level understanding of hospice coverage, claims administration, and program integrity considerations.
Why This Topic Matters
Hospice claims and compliance involve multiple payers, contractor types, and federal fraud and abuse laws. Understanding the overview helps organizations identify which general rules and manuals may affect billing, physician relationships, and Medicare participation.
What You Will Learn
- How hospice services are positioned within Medicare payment administration
- Which broad federal fraud and abuse laws are associated with hospice services
- What role CMS manuals and contractor guidance play in hospice-related claims and compliance
- How hospice billing considerations can differ by physician relationship and care setting
Who Should Read This
- Medical coders
- Medical billers
- Hospice administrators
- Compliance officers
- Physicians
- Revenue cycle staff
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