NewsLine - April 2013 - (Page 8)

and Abuse What You Need to Know and Do By Judi Lund Person, BA, MPH I n hospice these days, we are hearing a great deal about audits, edits, and fraud and abuse. So why is this happening? And what, as a hospice professional or board member, do you need to know and do? 8 NewsLine First, Let’s Look at the National Landscape As a result of the Affordable Care Act (ACA), the federal government now has tougher rules and sentences for those convicted of fraud and abuse, along with an additional $350 million (over 10 years) to enhance our nation’s fraud efforts.1 Some of this money is being spent on impressive tools and methods to help identify and investigate possible incidents, such as: •  nhanced screening (including E license checks and site visits); • State-of-the-art predictive modeling technology; and •  enior Medicare Patrols, groups of S senior volunteers who educate and empower their peers to identify, prevent and report healthcare fraud. A Healthcare Fraud Prevention Partnership was also established in 2009, and is comprised of representatives from the federal government and state and private organizations, including insurers. Its goal is to prevent healthcare fraud on a national scale by exchanging information among partners and performing sophisticated analytics on industry-wide data to detect and predict fraud schemes.

Table of Contents for the Digital Edition of NewsLine - April 2013

New Research Validates That Hospice Saves Medicare Big Dollars
A Message From Don
NHPCO HAN’s Advocacy Strategy for the Hill
Simione Consulting (display ad)
Hospice Education Network (display ad)
Fraud and Abuse
Make an Impact: African PC Nursing Scholarship Fund (display ad)
Honoring Our Four-Legged Volunteers
Creating a Volunteer-Inclusive Culture
Do Your Colleagues Know They’re NHPCO Members Too?
New—Lighthouse of Hope Fund
R2R: Helping Hospice Staff Raise Needed Funds
A Great Resource for Your Referral Partners
Revised State Hospice Profiles (display ad)
NHPCO’s HPC Professional Scholarship Program (display ad)
Member News and Notes
Compliance Tip of the Month
Videos Worth Watching

NewsLine - April 2013