OIG Report on Medicare Hospice Use of General Inpatient (GIP) Level of Care
The Department of Health and Human Services’ Office of the Inspector General (OIG) recently issued a Memorandum Report to the Center for Medicare & Medicaid Services (CMS) on Medicare Hospice: Use of General Inpatient Care, OEI-02-10-00490. This report is based on general inpatient care (GIP) provided to Medicare hospice beneficiaries in 2011.
Hospice GIP is for pain control or symptom management provided in an inpatient facility that cannot be managed in other settings. The care is intended to be short-term and is the second most expensive level of hospice care available after continuous care. GIP may be provided in one of three settings: a Medicare-certified hospice inpatient unit; a hospital; or a skilled nursing facility (SNF). CMS staff has expressed concerns about possible misuse of GIP, such as care being billed for but not provided, long lengths of stay, and beneficiaries receiving care unnecessarily.
The OIG found that the majority of GIP care was provided in hospice inpatient units as opposed to hospitals or SNFs. Twenty-three percent of Medicare hospice beneficiaries received GIP during the year. One-third of beneficiaries’ GIP stays exceeded five days, with 11 percent lasting 10 days or more. The hospices that used inpatient units provided GIP to more of their beneficiaries and for longer periods of time than hospices that used other settings.