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Review of Medicaid Hospice Payments Made by Massachusetts for State Fiscal Years 2007 and 2008

02-17-2011 | Audit (A-01-10-00004) | Complete Report

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Spotlight: Hospice Care Claim Problems

Woman in hospital bed Hospice care is an important and personal service for terminally ill Medicare beneficiaries, yet it doesn't escape the problems of fraud, waste, and abuse.

Our review found that the Massachusetts Executive Office of Health and Human Services (the State agency) did not use the correct per diem rate, make the appropriate payment reduction, or reduce Medicaid payments to hospices by the amount of beneficiaries' financial contributions for 2,056 of the 5,304 claims we reviewed for State fiscal years 2007 and 2008. As a result, the State agency's Federal claim was overstated by a total of $1.7 million ($826,000 Federal share).