CMS Tasks Surveyors With Fraud Detection

CMS Tasks Surveyors With Fraud Detection

CMS' memo about “Ensuring Consistency in the Hospice Survey Process,” reminds hospices to expect some survey problems could be reported to CMS for fraud investigations. It says, in part:
While the primary purpose of SA (state agency) and AO (accrediting organization) surveys is to determine compliance with the Medicare Hospice CoPs, there are several elements of the survey process that can uncover concerns that would necessitate a referral to CMS for potential fraud.
It also encourages hospice providers to access free online tools that promote compliance, referring hospice professionals to CMS' Resources to Improve Quality of Care:
Check out CMS’s new Quality in Focus interactive video series. The series of 10–15 minute videos are tailored to provider types and aim to reduce the deficiencies most commonly cited during the CMS survey process, like infection control and accident prevention. Reducing these common deficiencies increases the quality of care for people with Medicare and Medicaid.
Learn to:
• Understand surveyor evaluation criteria
• Recognize deficiencies
• Incorporate solutions into your facility’s standards of care
While the memo didn't introduce anything new to the hospice industry and its workforce, CMS did use the memo as an attempt to refocus hospice on ever-tightening scrutiny that is squeezing hospice agencies.

Here's the link to download your own PDF of the QSO-25-06-hospice memo

Be well.


Beth 
Back to blog

Leave a comment