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How Emerging Hospice Regulations Could Impact Providers

Hospice News

Centers for Medicare & Medicaid Services (CMS) has honed in on hospice program integrity, rolling out a swath of new measures to reduce fraud, waste and abuse in the space. A report from OIG found that roughly one-third of Medicare claims for hospice GIP services are billed in error, the OIG indicated.

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Care Plans Will Be a Key Issue as CMS Updates Hospice Survey Processes

Hospice News

Centers for Medicare & Medicaid Services (CMS) has implemented significant changes to the hospice survey process effective Jan. The OIG report indicated that about 20% of hospices surveyed by regulators or accreditors between 2012 and 2016 had a condition-level deficiency that posed a serious safety risk and included detailed examples.

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US Justice Department’s Spotlight on Hospice Sends ‘Powerful Message’ to Fraudulent Operators

Hospice News

DOJ counts hospice claims among the root causes of rising Medicare costs in recent years, according to Lisa Miller, deputy assistant attorney general overseeing the department’s Crime Fraud Section. Medicare hospice claims represent a solid chunk, according to regulators. million.

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OIG’s Hospice GIP Audit Fueled by Inappropriate Billing; Nearly One-Third of Claims Have Errors

Hospice News

Increased regulatory and clinical oversight is needed to address common billing and documentation errors related to hospice general inpatient care, according to the U.S. Roughly one-third of Medicare claims for general inpatient hospice services (GIP) are billed in error, the OIG indicated.

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The Rise of Malpractice Claims Against NPs

Daily Nurse

Centers for Medicare and Medicaid Services. percent of all claims in the 2022 dataset, compared to 13 percent in the 2012 dataset. Family and adult-gerontology primary care have consistently represented the majority of NP claims across 2012, 2017, and 2022 claim report datasets.

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The Rise of Hospital at Home

AlayaCare

The Centers for Medicare & Medicaid Services (CMS) , for instance, announced a new strategy to add flexibility to the U.S. This was the case well before COVID-19, as hospital-at-home programs have proven successful at improving patient outcomes while reducing health care costs (as evidenced in this 2012 Johns Hopkins study ).

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PEPPER Report: Target areas for rehab

Rehab Realities by Renee Kinder

This will be either a patient control number (found at form locator 03a on the UB-04 claim form) or a medical record number (found at form locator 03b on the UB-04 claim form) for a traditional Medicare Part A Fee-for-Service patient who received services from July 1, 2021, through Sept. 30, 2021 (“from” or “through” dates on a paid claim).