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The soon-to-be-implemented hospice Special Focus Program (SFP) from the U.S. Centers for Medicare & Medicaid Services (CMS) could produce misinformation that could interfere with access to care. It might make them even fearful about hospice care, which is the last thing we want to see happen. The program, set to begin Jan.
The past year has seen a slew of regulatory developments aimed at improving quality and combatting fraud in the hospice industry. The first was two July 2019 reports on hospice quality from the Office of the Inspector General (OIG) in the U.S. The Hospice Special Focus Program Finalized in the U.S.
Hospices coast-to-coast have undergone leadership transitions, including changes in legal executives and a slew of newly appointed CEOs, among other roles in the industry. Texas-based New Day provides home health, hospice, palliative and personal care services across 31 locations in Illinois, Kansas, Missouri and in its home state.
Centers for Medicare & Medicaid Services has made public its first cohort for the hospice Special Focus Program (SFP). Finalized in the 2024 home health payment rule, the program is designed to identify poor performing hospices, mandate quality improvement and in some cases impose additional penalties. million annually.
Stakeholders and policymakers who shape the hospice industry are making connections between a provider’s tax status and quality indicators. Their perceptions could have significant repercussions on the outlook of hospice investments. More private equity (PE) investors have stepped into the hospice and home health space in recent years.
Beth Van Duyne (R-Texas) and Jimmy Panetta (D-California) have introduced a bill that would reform aspects of the hospice Special Focus Program (SFP). If enacted, the Enhancing Hospice Oversight and Transparency Act also would increase the penalty for hospices that do not report quality measure data to 10% by 2027, up from 4% currently.
Maryland-based Hospice of the Chesapeake has increased its return rates for Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys through a performance improvement project. CAHPS surveys are among the most important sources of hospice quality data. to 29%, with further improvement expected as time goes on.
Quality, compliance and financial stability are top of mind in hospice merger and acquisitions (M&A) as this year comes to an end. Growing demand is among the constants driving investor interest in the hospice space, according to Tom Lillis, partner at the Kentucky-based firm Stoneridge Partners Strategic Consulting.
Underserved neurological patients Patients with neurodegenerative diseases are less likely to receive hospice care compared to others, according to a recent study published in the Neurology journal. million Medicare decedents who died in 2018 and examined the differences in hospice utilization during the last year and a half of life.
Centers for Medicare & Medicaid Services (CMS) has not responded to congressional concerns about the hospice Special Focus Program (SFP). Set for 2025 implementation, the SFP promises to identify hospices delivering poor quality care and target them for improvement remedies. Van Duyne told Hospice News in an email.
As both Chief Medical Officer and Chief Innovation Officer for the National Partnership for Healthcare and Hospice Innovation, Dr. Cameron Muir has committed to help guide operators towards a value-based future. Muir joined the organization in 2019 as its chief of clinical innovations. So that’s one.
Calls have grown louder for an overhauled design of the MedicareHospice Benefit, but the path towards change is riddled with contrasting views over regulation, policy and payment structures. One part of the issue is that hospice reimbursement has not kept pace with evolving patient needs, Grant said.
Though the numbers are still relatively low, spending on early palliative care rose between 2010 and 2019 for patients with advanced cancers, a recent study found. The increase was associated with earlier palliative care referrals and providers having a hospice and palliative specialist on staff.
Regulators have been zeroing in on longer lengths of stay in hospice, but patients with dementia may be caught in the crossfire. . Two policy changes have corresponded with reductions in hospice enrollment among dementia patients, a new study in the Journal of the American Medical Association has found.
More than a dozen hospice advocacy groups have called on congressional leadership to intervene in a proposed 2.7% bump in Medicare payments, which they say is insufficient in light of COVID-19 and staffing headwinds. CMS in April released the 2023 proposed payment rule for hospice providers, including the 2.7%
Medicare claims for unrelated services creates serious financial and legal risks for hospice providers — even if they are not the ones who sent the bill. During recent years, payouts for non-hospice services provided to Medicare beneficiaries have tipped into the billions. These “unrelated” payments have been soaring.
The families of patients who received care from nonprofit hospices give their providers higher marks on quality than those who went with for-profits, a RAND Corp. These findings are particularly pressing given the striking growth of for-profit hospices, which have profit incentives that have been shown to affect how they care for patients.”
Centers for Medicare & Medicaid Services will end the hospice component of the value-based insurance design model (VBID) as of Dec. Often called the “hospice carve-in,” the program was designed to test coverage of hospice care through Medicare Advantage, in addition to some coverage of palliative care and transitional care.
million in improper payments in 2019. 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. OIG has already recommended that the U.S.
The two lawmakers, along with others, also brought forth a second bill designed to ensure that hospice patients who need blood transfusions can receive them. Rosen and Murkowski, initially tried to pass the palliative care training bill in 2019, and then again 2021. Jacky Rosen (D-Nev.) Established in 1972, NHSC is part of the U.S.
Centers for Medicare & Medicaid Services (CMS) has finalized its 2024 home health rule, including the implementation of a hospice Special Focus Program (SFP). The rule also finalizes the proposed “36-month”rule for hospice providers.
Limiting hospice access for dementia patients is likely to increase overall health care costs at the end of life, according to recent research. During the past decade, Medicare beneficiaries with dementia who utilized hospice had lower overall health care costs than those who did not, according to the Health Affairs study.
Centers for Medicare & Medicaid Services (CMS) has reiterated that the agency will not allow hospices to recertify patients after the COVID-19 public health emergency expires. . Face-to-face encounters for purposes of patient recertification for the Medicarehospice benefit can now be conducted via telehealth (i.e.,
Two individuals in California have been arrested for their roles in a $54 million scheme to defraud Medicare for hospice and diagnostic testing. From March 2019 to August 2024, these companies allegedly submitted more than $54 million in fraudulent claims to Medicare for services that were never provided and not needed.
Program integrity issues that have heated up in the hospice space during the past five years reached a boiling point in 2023. Hospice providers have seen an array of increased regulatory oversight in 2023. There is scrutiny on hospice care [that’s] setting the stage for the next phase of what hospice oversight looks like.
Hospice providers will be looking to Congress in 2024 to address issues related to program integrity, quality improvement and industry-wide workforce pressures. As legislative efforts develop, hospices may want to focus their attention on a few key legislators. We don’t have confidence in the algorithm that they proposed.
Cameron Muir has been named as the new CMO of the National Partnership for Healthcare and Hospice Innovation (NPHI). His new title signals the organization’s strategic plans to reshape hospice care delivery through patient-centered, innovative approaches, according to NPHI CEO Tom Koutsoumpas.
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 served as a physician for two Pasadena-based providers, Saint Mariam Hospice Inc. and Arcadia Hospice Provider Inc.
Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure, calling for a payment model demonstration designed to support greater access to palliative care. Many hospices are currently participating in other CMMI programs, including the value-based insurance design demonstration (Medicare Advantage carve-in.
Centers for Medicare & Medicaid Services (CMS) has been gradually implementing changes to the hospice survey process and enforcement remedies, including civil monetary penalties in some instances. The monetary penalties were among seven enforcement remedies introduced through the HOSPICE Act and subsequent CMS rules.
As the hospice community takes its first steps into value-based reimbursement, stakeholders have an opportunity to re-examine elements of the MedicareHospice Benefit that may be outdated, according to some providers. The hospice benefit became a formal part of Medicare in 1983. Initially, the U.S.
The recent article by the New Yorker and ProPublica that branded “hospice” as a profiteering “hustle” was an outrageous misrepresentation of the provider community. The National Hospice & Palliative Care Organization (NHPCO), for instance, filed an amicus brief with the court. Even when a hospice plays by the rules, death does not.
Centers for Medicare & Medicaid Services’ (CMS) decision to extend the value-based insurance design (VBID) model through 2030: patients’ social needs, health equity and improved care coordination. This includes the hospice benefit component, often called the Medicare Advantage carve-in, CMS confirmed.
Centers for Medicare and Medicaid Services’ (CMS) proposed rule designed to strengthen oversight of those institutions. Three such organizations currently have deeming authority for hospices, The Joint Commission, the Accreditation Commission for Health Care (ACHC) and Community Health Accreditation Partner (CHAP).
Gavin Newsom (D) recently approved legislation that expands upon last years’ moves to strengthen hospice oversight in the state, among other enforcement actions. The bills — Senate Bill 664 and Assembly Bill 1280 — followed a Los Angeles Times investigation into alleged misconduct among hospice providers statewide. California Gov.
trillion in 2021, according to a new analysis from the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS). share in 2019. Published annually at the end of the year, the analysis does not specifically call out hospice expenditures. in 2020, according to the Medicare Payment Advisory Commission.
Centers for Medicare & Medicaid Services (CMS) is seeking answers from the hospice community — including some around utilization patterns and non-hospice spending. The recently proposed 2024 hospice payment rule contained a 2.8% of hospice days and 93.7% As many as 72.2% As many as 72.2%
In enacted, the recently reintroduced Palliative Care and Hospice Education Training Act (PCHETA) could make a dent in the recruitment barriers that hospices keep hitting. Hospice] has to become a part of the education of medical students, nursing and social workers at large,” Lee told Hospice News.
As federal regulators intensify their focus on hospices, operators may begin seeing an influx of Recovery Audit Contractor (RAC) activity. Centers for Medicare & Medicaid Services (CMS) contracts with RACs to conduct post-payment reviews designed to recover any funds that may have been overspent.
Recent research has uncovered ties between improved hospice utilization rates among patients receiving home health services. Researchers from New Jersey-based Rutgers University’s School of Nursing have found that patient preferences leaned toward home-based hospice services following home health experiences.
The hospice and senior care provider Helios Care is partnering with the integrated health system Bassett Healthcare Network to bring more extensive access to hospice and palliative care to patients in central New York. Formerly known as Catskills Area Hospice and Palliative Care, the organization rebranded as Helios in 2019.
(NASDAQ: PNTG) has purchased California-based Ardent Hospice and Palliative Care in the San Diego area for an undisclosed amount. Ardent, which also offers home health care, serves between 20 and 50 hospice patients per day, according to National Hospice Locator. The company received its Medicare certification in 2013. “We
The four largest hospice industry organizations are urging congressional lawmakers to mandate changes to the Special Focus Program (SFP) currently set to begin in 2024. Centers for Medicare & Medicaid Services (CMS) last week issued its 2024 home health payment rule , which contained several hospice provisions.
Hospices have been advocating for lawmakers and regulators to take action on curbing fraud, supporting veterans and bolstering the health care workforce. Battling fraud Reports of unethical or illegal practices have surged, particularly among hundreds of newly certified hospices in California, Texas, Nevada and Arizona. Recently Rep.
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