Hospice News

MAY 17, 2024

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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JULY 26, 2024

A hospice physician in California is facing up to a decade in prison after pleading guilty for their involvement in a kickback fraud scheme that bilked Medicare of nearly $30 million. Contreras defrauded Medicare of nearly $4 million in false and fraudulent hospice claims from July 2016 to February 2019, according to the plea agreement.

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DECEMBER 1, 2022

Auditors will review the impact of hospice fraud on the state’s Medicare and Medi-Cal programs, investigate licensing procedures, and evaluate California’s current oversight processes and capabilities. Medi-Cal is the state’s Medicaid program. Last week, a group of hospice industry organizations wrote to U.S.

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JUNE 27, 2022

Social and economic factors like these drive 40% of health outcomes, according to the Better Medicare Alliance. For example, 2016 research found that close to 3.6 Health care providers, payers, and other stakeholders are increasingly paying more attention to both social determinants and palliative care, including Medicare and Medicaid.

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DECEMBER 12, 2023

From 2016 through 2019, the average share was 17.5%. Spending by Medicare, hospice’s principal payer, accounted for 21% of the total national expenditures, hitting $944.3 Growth in Medicare spending also dropped to 5.9% Economic patterns also reflect the growing presence of Medicare Advantage. billion in 2022.

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OCTOBER 4, 2022

The Center for Medicare & Medicaid Innovation (CMMI) is developing new reimbursement pathways for palliative care. As part of that process, CMMI is applying elements of its Medicare Care Choices Model (MCCM) demonstration, which ended Dec. They also were more likely to eventually accept the Medicare Hospice Benefit.

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APRIL 6, 2023

Kevin Sarkisyan, of San Gabriel Hospice & Palliative Care, pleaded guilty to one count of conspiracy to defraud the government for his involvement in submitting false enrollment applications to Medicare that hid the “real owners of a hospice company,” according to court documents. Ghadimi is accused of misusing Medicare payments.

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Hospice News

SEPTEMBER 2, 2022

Closing these gaps is a rising priority in payment model demonstrations by the Center for Medicare & Medicaid Innovation (CMMI). This includes programs such as Medicare Advantage, the Medicare Care Choices Model, Primary Care First, and Accountable Care Organizations (ACOs). The center is a component of the U.S.

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FEBRUARY 27, 2023

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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APRIL 17, 2024

Centers for Medicare & Medicaid Services’ (CMS) review and appeals process, according to CEO Greg Hagfors. The provider recently celebrated the 45th anniversary of its founding, which preceded the establishment of the Medicare Hospice Benefit. 1, 2016 and Dec.

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JULY 11, 2022

million seniors who reside in Illinois are 85 or older, and 40% of Medicare beneficiaries in the state have four or more chronic conditions, according to HCCI. Centers for Medicare & Medicaid Services (CMS) is replacing the Global and Professional Direct Contracting (GPDC) model with ACO REACH. million primary care visits in 2016.

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Hospice News

AUGUST 14, 2023

Among those demos is the Medicare Care Choices Model (MCCM), which ran between 2016 and 2021. Community-based palliative care has the potential to improve end-of-life care and Medicare program costs.” It’s a genesis for expansion in terms of improving or maintaining quality of care and driving savings in Medicare,” Baird said.

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APRIL 22, 2024

Centers for Medicare and Medicaid Services’ (CMS) proposed rule designed to strengthen oversight of those institutions. The first OIG report indicated that about 80% of hospices surveyed by regulators or accreditors between 2012 and 2016 had deficiencies in compliance. Some accreditation organizations (AOs) have balked at the U.S.

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SEPTEMBER 8, 2023

Center for Medicare & Medicaid Services (CMS), the National Institute on Minority Health and Health Disparities (NIMHD), the California Black Health Network (CBHN) and the California Health Care Foundation (CHCF). The study was funded in part by the U.S.

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NOVEMBER 16, 2022

Minority groups represented 28% of Florida’s seniors in 2016, according to a report from the state’s Department of Elder Affairs. Socioeconomically, 29% of seniors statewide fell into a “low-income” category during 2016, while 30% live in rural areas, according to the Elder Affairs report. Utah held the highest rate at 60.5%

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Hospice News

MARCH 13, 2024

The first 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. The agency identified 313 hospices nationwide as “poor performers” in 2016, representing 18% of the total number of providers surveyed that year.

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Hospice News

JUNE 21, 2023

Chuck Grassley (R-Iowa) and 59 bipartisan co-sponsors have reintroduced legislation that would expand Medicare coverage of telehealth and make permanent flexibilities implemented during the COVID-19 public health emergency. The first version of the bill was introduced in 2016. Brian Schatz (D-Hawaii), Roger Wicker (R-Miss.),

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Hospice News

MARCH 23, 2023

On the patient side, Medicare beneficiaries face out-of-pocket costs when advance care planning is performed in any setting outside of an annual wellness visit. Across 150 different studies, white adults represented nearly two-thirds (65.1%) of roughly 800,000 individuals who had completed advance directives between 2011 and 2016.

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JULY 10, 2023

million seniors who reside in Illinois are 85 or older, and 40% of Medicare beneficiaries in the state have four or more chronic conditions, according to HCCI. million home-based primary care visits during 2016, up from less than 1 million in 1996, the study found. million primary care visits in 2016. About 12% of the 2.1

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JULY 25, 2022

“In total, Atoyan, Karapetyan and others caused the agencies to submit over 8,000 claims to Medicare for the cost of home health care and hospice services. Based on those claims, Medicare paid the agencies approximately $31 million,” the U.S. Justice Department indicated in a statement. Attorney Phillip Talbert.

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MARCH 14, 2024

Centers for Medicare & Medicaid Services (CMS) has developed a financial incentive to foster better performance on the measure, the service-intensity add-on. CMS introduced SIA in 2016. Staffing shortages continue to impact providers’ ability to appropriately triage patients’ care needs,” Harrison said.

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JANUARY 16, 2023

Researchers analyzed records for 43,200 veterans with prior hospitalization who had received primary care at a VA site between October 2016 and September 2019. They included VA hospice encounters in the outcome but not enrollment in a home hospice program, nursing home hospice center or Medicare-paid hospice.

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OCTOBER 13, 2022

Social and economic factors like these drive about 55% of individuals’ health outcomes, according to the Better Medicare Alliance. For example, 2016 research found that close to 3.6 The need to address social determinants has been cited as an impetus for the push toward value-based reimbursement. Case in point, the U.S.

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DECEMBER 19, 2023

Centers for Medicare & Medicaid Services (CMS). Celtic and Residental merged in 2016 to form Graham Healthcare Group. .” By 2030, seniors are projected to make up nearly a quarter (22.3%) of the overall Illinois population, up from 16.6% currently, according to the U.S. Census Bureau.

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SEPTEMBER 20, 2023

Previously, he was head of growth at Mavencare, and served in sales manager and director roles at Hometeam from 2013 to 2016. Guaranteed serves Medicare and Medicaid patients across five counties in southern California, including the Los Angeles region. Cottrell has led the nonprofit hospice organization since September 2016.

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Hospice News

MAY 4, 2022

Former SouthernCare nurse Rhonda McClinton filed a qui tam complaint against the organization in 2016, alleging that the hospice provider submitted hospice claims to Medicare for patients who were not eligible and billed for services it did not provide.

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JANUARY 12, 2023

Justice Department accused the pair of submitting thousands of false claims to Medicare and of arranging more than $2 million in kickbacks in exchange for referrals. In total, Atoyan, Karapetyan and others caused the agencies to submit over 8,000 claims to Medicare for the cost of home health care and hospice services. “In

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DECEMBER 12, 2023

The first report shook the industry with findings that around 20% of hospices surveyed by regulators or accreditors between 2012 and 2016 had a deficiency that posed a serious safety risk. Many established services for the purpose of selling the license at a profit or defrauding Medicare. In response, the U.S.

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DECEMBER 14, 2022

Established in 2016, 1st Care provides home health and hospice in the Indianapolis area and surrounding counties across Central Indiana. The hospice utilization rate among Medicare decedents in Indiana reached 51.9% Similar to national trends, demographics are accelerating demand for hospice in the Hoosier State. This is up from 16.4%

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SEPTEMBER 21, 2023

Supreme Court ruled in favor of the plaintiff in 2016. The litigation first arose in 2008 when four former employees of Care Alternatives filed a qui tam complaint alleging that the New Jersey-based company billed Medicare for hospice services when patients were not eligible to receive them. Escobar” was an FCA case in which the U.S.

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SEPTEMBER 24, 2022

From a business perspective, patient populations who experienced longer lengths of stay boosted hospice margins by as much as 20% during 2016, according to a report from the Medicare Payment Advisory Commission (MedPAC). Centers for Medicare & Medicaid Services (CMS).

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Hospice News

SEPTEMBER 12, 2022

Established in 2016, Kore Cares is based in Sioux Falls, South Dakota, and provides personal, home-based care services to seniors in that area. among Medicare decedents, according to the National Hospice and Palliative Care Organization. This lagged behind the national average of 50.3%

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AUGUST 24, 2023

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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OCTOBER 7, 2022

Support for family caregivers is an important step towards controlling health care costs, particularly for Medicare and Medicaid, according to Greg Link, director of the Office for Supportive and Caregiver Services at ACL. The strategy also contains 150 recommendations for state and local government, as well as the private sector.

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OCTOBER 4, 2022

Hospice utilization among Medicare decedents in the state runs high and reached 52.1% The Trio deal marks Jet Health’s ninth acquisition since its establishment in 2016. Seniors are expected to make up more than 20% of the state’s population by 2030, up from 12.9% currently, according to the U.S. Administration for Community Living.

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Hospice News

AUGUST 30, 2022

among Medicare decedents in 2018, which is in line with that year’s national average, according to the National Hospice and Palliative Care Organization (NHPCO). Celtic and Residental merged in 2016 to form Graham Healthcare Group. The proportion of seniors older than 65 in Missouri’s population is expected to reach 19.1%

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Hospice News

AUGUST 17, 2022

In 2016, the legislature also approved a requirement that health care providers inform patients with a terminal prognosis of six months or less about hospice and palliative care. Centers for Medicare & Medicaid Services (CMS) for building their own Medicaid benefit, Sinclair indicated. Councils in other states also hit barriers.

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