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Medicare Claims for Unrelated Services Put Hospices at Risk

Hospice News

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. Centers for Medicare & Medicaid Services (CMS).

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How Palliative Care Could Help Break the SNF-to-Hospital Cycle

Hospice News

A dearth of coordination or integration between rehab teams and palliative care teams routinely forces some patients into a cycle between the hospital and the nursing home in their last year of life. These results appeared in a 2019 New England Journal of Medicine study titled “Rehabbed to Death.”

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CMS to Sunset Look-Alike Dual-Eligible Special Needs Plans in 2023

Hospice News

Centers for Medicare & Medicaid Services (CMS) in 2023 will phase out dual-eligibility special needs look-alike plans within Medicare Advantage. Close to 12 million people in the United States qualify for both Medicare and Medicaid. Some hospice patients rely on these plans for other health needs, such as nursing home costs.

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GAO: CMS Should Update Rules for Hospices Reporting Abuse or Neglect

Hospice News

Centers for Medicare & Medicaid Services (CMS) requires operators to report incidents of patient abuse and neglect that involve their staff. This would bring the hospice rules in line with those used in long term care. Government Accountability Office (GAO) has recommended. NAHC also called on the U.S.

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From Sea to Shining Sea: State Palliative Care Laws Yield Mixed Results

Hospice News

Among the applicants to join the council was Barbara Hansen, CEO of the Oregon Hospice & Palliative Care Association, who became a member in 2018. The Oregon advisory group began producing a website to inform health care providers about palliative care, with a particular focus on long term care organizations.

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Regulatory Focus in Hospice Giving Buyers Pause in M&A Deals

Hospice News

A leading cause of fraud involves hospices billing Medicare for services for which patients were not eligible, according to a 2021 report from Bass, Berry, & Sims. Two OIG reports in 2019 shook the industry with findings that condition-level deficiencies posed safety risks to patients.

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Gilchrist and Luminis Health Form Joint Venture, Find ‘Sweet Spot’ in Health Care Delivery

Hospice News

It extends the organizations’ existing partnership for hospital-based palliative care services, bringing this care into more settings such as hospitals, physician offices, long-term care facilities and in the home. Luminis Health was established in 2019 and generates an annual $1.1 independent of the JV.