Investigators criticized by end-of life advocates

In the May 1999 issue of Hospice Management Advisor, the cover story examined whether overzealous investigators were unfairly characterizing innocent billing errors as fraud and abuse. Hospice experts complained that the federal government’s effort has left honest agencies with the burden of defending themselves from investigators bent on finding questionable billing practices.

On its Web site, Last Acts, a Robert Wood Johnson Foundation-funded, nonprofit organization dedicated to promoting awareness about palliative care and other end-of-life issues, made a similar observation.

"Some observers now argue that access to hospice care is being limited by excessive government oversight, namely a three-year investigation conducted by the Office of Inspector General (OIG) of the Department of Health and Human Services into alleged fraud and abuse in the Medicare hospice reimbursement program," said the article.

Critics of Operation Restore Trust said federal investigators’ focus on hospice lengths of stay may be part of a larger pattern of punitive oversight of the entire Medicare program.