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

Hospice News

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.

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Death Doulas, Community Health Workers Collaborations Can Aid Hospices, But Resources Are Scarce

Hospice News

EOLDs have had a growing presence in the serious illness and end-of-life care space, but their services are not reimbursed by Medicare or other insurance, according to Jane Euler, co-founder and chief doula of Present for You LLC. However, building these collaborations has come with financial barriers.

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

Hospice News

These results appeared in a 2019 New England Journal of Medicine study titled “Rehabbed to Death.” Even more so, specific Medicare and Medicaid policies perpetuate this cycle. In the study, researchers present the case of an independent 87-year-old woman with moderate dementia admitted to the hospital with pneumonia.

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

Hospice News

In 2019, for example, the percentage was 66%. Centers for Medicare & Medicaid Services (CMS) has developed a financial incentive to foster better performance on the measure, the service-intensity add-on. Social worker visits in the last days of life also rose to 9% in 2021, up from 7% in 2020. CMS introduced SIA in 2016.

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Limited Access to Post-Acute Care Fuels Readmission Rates

Hospice News

Centers for Medicare & Medicaid Services (CMS) penalizes hospitals for readmissions rates that exceed certain thresholds, but the agency does not account for the supply of post-acute providers available to patients in a providers’ service region.

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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 Climbing ‘Steeper Stairs’ as UPIC, TPE Audits Spike

Hospice News

Centers for Medicare & Medicaid Services (CMS) contracts UPICs to investigate instances of suspected fraud, waste and abuse. million in FY 2019 But UPICs and hospice providers sometimes disagree on what constitutes an improper payment. CMS audits present more than merely administrative or procedural hurdles.

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