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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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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. Some hospice patients rely on these plans for other health needs, such as nursing home costs. Of those, about 3.8

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Hospice Medical Director Receives 50-Month Prison Sentence for $150M Fraud

Hospice News

The Texas Medical Board suspended his medical license in 2019, when he pleaded guilty to the fraud charges. They enrolled patients with long-term incurable diseases such as Alzheimers and dementia as well as patients with limited mental capacity who lived at group homes, nursing homes and in housing projects.”

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Hospices Acquired by PE Firms, Publicly Traded Companies See Increases in Dementia Patients

Hospice News

in 2019, according to the National Hospice and Palliative Care Organization (NHPCO). Dementia-related illnesses are the fastest growing primary terminal diagnosis among hospice patients. A little more than 20% of hospice decedents in 2020 suffered from dementia, up from 18.5% of terminal diagnoses in 2020, while cancer accounted for 7.2%.

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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. GAO determined that under current rules abuse reports from hospices may be less complete or timely than those from nursing homes and hospitals. NAHC also called on the U.S.

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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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Hospice Length of Stay: Balancing Patient Needs Against Regulatory Compliance

Hospice News

Are you in an outlier scenario with your data that Medicare contractors are looking at? Centers for Medicare & Medicaid Services (CMS) and the U.S. In 2020, the average length of stay for Medicare patients enrolled in hospice was 97.0 according to the Medicare Payment Advisory Commission. That number reached 92.5

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