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Early Palliative Care Spending Rose Over the Last Decade

Hospice News

” The study cohort included Medicare beneficiaries 65 or older who were diagnosed with distant-stage female breast, colorectal, non-small cell lung, small cell lung, pancreatic or prostate cancers between 2010 to 2019 with survival of at least six months. in 2017 through 2019 compared to 51% in 2010-2013.

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Saad Healthcare to Pay $3M False Claims Act Settlement

Hospice News

The hospice was accused of knowingly submitting Medicare claims for patients who were not terminally ill. Respectful and appropriate end-of-life care is the crux of the hospice benefit under Medicare, said Principal Deputy Assistant Attorney General Brett A. Justice Department. Attorney Keith A.

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Canon Healthcare Owner Receives Prison Sentence, $42 Million Fine in Fraud Case

Hospice News

The court also ordered Akula to repay $42 million in fraudulent Medicare billing claims made between January 2013 and December 2019, which totaled roughly $84 million during that six-year span. The charges included fraudulent claims for physician services and home visits, as well as manipulation of Medicare billing codes.

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Former Canon Healthcare Owner Convicted for $47 Million in Hospice Fraud

Hospice News

Between 2013 and 2016, the company billed Medicare for $62 million and received $47 million in payments, according to the U.S. Between 2013 and 2017, Canon billed Medicare for 2,800 claims per month, totalling $15.3 Justice Department.

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Payer Partnerships ‘Critical’ in VBID: Ohio’s Hospice, Pure Healthcare Contract with Aetna

Hospice News

. “This would allow for greater flexibility than the current Medicare model provides.” . Often called the Medicare Advantage hospice carve-in , the VBID demonstration project took effect January 1, 2021. The carve-in is designed to assess payer and provider performance related to hospice within Medicare Advantage.

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MA Beneficiaries More Likely than Fee-for-Service Patients to Enter Hospice from Community Setting

Hospice News

Medicare Advantage (MA) beneficiaries are more likely to enroll in hospice from a community setting than patients in traditional fee-for-service programs. million patients who elected hospice in the last 90 days of life during the years 2011, 2013, 2016 and 2018. .” This is close to half of all Medicare beneficiaries.

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Providers Leverage Efficiency to Boost Palliative Care ROI

Hospice News

Payers, including Medicare, like to see providers reduce the costs of care. Centers for Medicare & Medicaid Services (CMS) has reimbursed palliative care through a fee-for-service model that only covers physician and licensed independent practitioner services, rather than the full range of interdisciplinary care.