Medicare Paying out Billions for Improper Hospice Care

Over the past decade, the number of people discharged alive from hospice care has soared, partly because hospice firms are enrolling patients who are not actually dying, a Washington Post investigation has found.

These patients, whose care is paid for largely by Medicare, are more profitable since they require fewer visits and remain enrolled for longer, according to the Post.

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The Post's analysis focused on hospice industry records in California, which showed that the proportion of patients released alive from hospice care rose roughly 50 percent between 2002 and 2012, while the average length of stay jumped substantially as well.

Profit per patient quintupled over that time, reaching $1,975, the records showed. Medicare reportedly pays about $150 a day per Hospice patient for routine care, whether or not the Hospice company sends out a nurse or health care worker.

According to MedPAC, the Medicare watchdog created to advise Congress, that financial incentive could be costing billions of dollars a year. In 2011, MedPAC found that nearly 60 percent of Medicare's expenditure of $13.8 billion on hospice services went to patients who received care for longer than six months.

MedPAC has recommended reforming hospice payments in order to eliminate the incentive for improper care, according to the Post. But so far, no reform steps have been taken.

Meanwhile, four of the 10 biggest for-profit hospice companies in the country, including AseraCare and Vitas, have reportedly been sued by whistleblowers for allegedly taking in patients who did not need hospice care.

And in May, the Justice Department joined in, filing suit against Vitas, the country's biggest hospice provider, alleging false Medicare billings.

"The Medicare hospice benefit is intended to provide patients nearing the end of life with pain management and other palliative care to make them as comfortable as possible,” said Stuart F. Delery, acting assistant attorney general for the Justice Department's Civil Division.

“Too often, however, we hear reports of companies that abuse this critical service by using aggressive marketing tactics to push patients into services they don’t need in order to get higher reimbursements from the government."

AseraCare and Vitas have reportedly denied all of the allegations made in the cases.

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