During that time period, Kaiser NW allegedly billed Medicare for hospice services that had been provided by the Kaiser Northwest Region Hospice without obtaining written certifications of terminal illness required by Medicare.
Medicare hospice care providers, like Kaiser Northwest Region Hospice, must obtain written certifications of terminal illness for each hospice beneficiary’s initial certification period (the first 90 days of care) from the medical director of the hospice and the individual beneficiary’s attending physician, if the beneficiary has one. Medicare requires a hospice to obtain these certifications prior to billing Medicare in order to help ensure that hospice care is medically necessary, according to the release.
In June 2005, Kaiser NW submitted a report to the Department of Health and Human Services’ Office of Inspector General disclosing that between Oct. 2000 and March 2004, there were instances in which Kaiser NW did not obtain written certifications of terminal illness for hospice beneficiaries prior to billing Medicare for the beneficiaries’ initial certification period. The settlement announced today resulted from the company’s disclosure.
“By requiring that healthcare providers comply with Medicare’s standards, we ensure that beneficiaries receive hospice care that is medically necessary and meets appropriate medical standards,” Tony West, Assistant Attorney General for the Justice Department’s Civil Division, said in the release. “We encourage disclosures of this nature, and we consider them essential to ensuring the protection of the Medicare Trust Fund.”
Read the DOJ release on the Kaiser NW $1.83 million settlement.
