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OIG Estimates $42 Million in Improper Medicare Payments for Advance Care Planning

Hospice News

Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently reported the results of its audit of advance care planning (ACP) billing practices among Medicare-certified physicians and other health care providers. Office settings accounted for 61% of all ACP billing between 2016 and 2019, according to OIG.

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Partners in Care Sues HHS Over Claims Denials

Hospice News

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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Hospices Pursue Home-Base Primary Care Via HCCI Project

Hospice News

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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VA Study Finds 95% Increase in Palliative Care Utilization When Patients Have Access to Social Workers

Hospice News

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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Hospices Stepping Up Performance on Visits-in-Last-Days-of-Life Measure

Hospice News

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. Additional touchpoints with patients via telehealth is another factor contributing to improvements on the measure, Harrison said.

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Court Dismisses SouthernCare Fraud Allegations, Proceeds with Whistleblower Retaliation Complaint

Hospice News

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. The court granted SouthernCare’s motion on procedural and jurisdictional grounds.

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Housing Insecurity a Threat to Seniors, Poses a Risk for Hospice Providers

Hospice News

The depletion of a family’s financial resources is a greater predictor of aggressive treatment at the end of life than patient preferences or demographic factors, a 2016 study concluded. of Medicare Advantage individual plans offered the general supports benefit, as well as only 10.3% Department of Housing and Urban Development (HUD).

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