Hospice care is meant to ease the burden for patients and families facing tough end-of-life decisions. While the vast majority of providers are in the business to provide compassionate care, the unfortunate reality is that some companies have begun to offer hospice care with minimal credentialing, or in some cases, for outright fraudulent goals.
This is especially true in the state of Texas, which is listed alongside California, Nevada, and Arizona in the U.S. Centers for Medicare & Medicaid Services (CMS) expanded enhanced oversight program. Blue Water Hospice has worked exceptionally hard over our many years providing care to ensure that we are providing only the finest care and upholding the highest standards within industry best practices.
What “Expanded Oversight” Means
The CMS announced a “provisional period of enhanced oversight” in July 2023 for new hospices in the states mentioned above. This oversight includes a more thorough medical review of all claims before they are paid by Medicare. Additional review was recently announced by the CMS to combat fraud, waste and abuse within hospice, primarily among new startups in the field. These companies, if found to be noncompliant or providing fraudulent services, may see denial of claims or potentially even expulsion from the Medicare program.
In addition to actions taken by CMS, many state governments in these states and others across the country are seeking ways to obtain stronger oversight in the administration and practice of hospice. At Blue Water Hospice, we fully support efforts to root out waste and fraud so that those in care and their families can have peace of mind knowing that a decision to choose hospice will lead to quality, safe, and ethical care.
How to Protect Yourself and Your Loved One
Choosing a reputable hospice provider is an important decision. Here are some key steps to help you find the right one:
- Check Accreditation: Ensure the hospice is accredited by recognized organizations, like the Joint Commission or the National Hospice and Palliative Care Organization (NHPCO).
- Evaluate Services: Review the services offered, including pain management, emotional support, and bereavement services. Some hospices may also provide specialized care for certain conditions.
- Check Reviews and References: Look for online reviews and ask for references from families who have used their services.
- Visit and Ask Questions: If possible, visit the hospice and meet with staff. Ask about their approach to care, communication, and support for families.
- Staff Credentials: Look into the qualifications and experience of the hospice staff. This includes doctors, nurses, social workers, and volunteers.
- Trust Your Instincts: Choose a hospice provider that feels right for you and your loved one. Trust your feelings about the staff and their approach to care.
Taking the time to evaluate a provider closely is essential to choosing hospice care that is above board and provided by experienced professionals.
