Hospice News

DECEMBER 12, 2024

Centers for Medicare & Medicaid Services (CMS) has not responded to congressional concerns about the hospice Special Focus Program (SFP). Congress mandated the SFP in the Consolidated Appropriations Act of 2021 , which contained language from the Helping Our Senior Population in Comfort Environments (HOSPICE) Act.

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Hospice News

DECEMBER 27, 2024

Centers for Medicare & Medicaid Services value-based insurance design (VBID) model. Launched in 2017 by the Center for Medicare and Medicaid Innovation (CMMI), the VBID demonstration tested new approaches to reimbursement across a variety of health care settings.

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Hospice News

MARCH 14, 2025

The Medicare Payment Advisory Commission (MedPAC) has recommended to Congress a freeze on hospice payment increases starting in 2026. The 2021 aggregated Medicare hospice margin was 10.4%, according to MedPAC. million Medicare beneficiaries received services in 2023 from close to 6,500 providers, up from 5,900 the prior year.

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Hospice News

JUNE 29, 2022

Congressional legislators are casting doubts on regulatory oversight of Medicare Advantage plans over concerns about spending, claims denials, and end-of-life care. Department of Health & Human Services Office of the Inspector General (OIG), the Medicare Payment Advisory Commission (MedPAC), and the Government Accountability Office.

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Hospice News

MARCH 5, 2025

Some of the requirements stipulated that operators must be accredited and be Medicare certified. Other proposed requirements would prohibit a hospice program from accepting new patients or transferring their billing Medicare billing privileges in certain circumstances.

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Hospice News

MARCH 19, 2025

The seed for Texas-based Pallicare was planted at a chance meeting at a 2021 conference between Jonathan Fluhart, a management professional with a background in aerospace, technology, and hospice industries, and nurse practitioner Tiffany Hughes.

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Hospice News

JANUARY 17, 2025

Earl Blumenauers (D-Oregon)] proposal for reform incorporated both payment for some types of palliative care, and aspects of [the Medicare Care Choices Model ] that allowed some care and support prior to hospice election. Its complicated because there are so many treatments and interventions that are considered palliative.

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Hospice News

NOVEMBER 6, 2024

Hospices flagged by the SFP also will be surveyed every six months rather than the current three-year cycle and could face monetary penalties or expulsion from the Medicare program. The SFP has the authority to impose enforcement remedies against hospices with poor performance based on its algorithm.

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Hospice News

JULY 13, 2022

bump in Medicare payments, which they say is insufficient in light of COVID-19 and staffing headwinds. percent in 2021, according to the Bureau of Labor Statistics (BLS). The post Hospice Advocacy Groups Ask Congress for Action on Proposed 2023 Medicare Rates appeared first on Hospice News. Congress should urge [the U.S.

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Hospice News

MARCH 12, 2025

Pattersons alleged actions caused false claims to be submitted to Medicare, according to a report from the U.S. Dr. Patterson falsely certified individuals for hospice services under Medicare when they did not meet eligibility criteria, Special Agent in Charge John Morales for FBI El Paso said in a statement. Justice Department.

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Hospice News

JUNE 3, 2022

The Medicare Part A trust fund is still on track to run short of money before the decade is out, but not as quickly as previously anticipated. By 2028, Medicare would have sufficient dollars to cover 90% of Medicare expenses. Annual raises in reimbursement and Medicare residual costs spurred the higher rate of increase.

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Hospice News

APRIL 16, 2025

Centers for Medicare & Medicaid Services (CMS) include five areas of social determinants of health: food and housing insecurity, transportation needs, utility difficulties and interpersonal safety. Screening tools developed by the U.S.

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Hospice News

DECEMBER 9, 2024

Centers for Medicare & Medicaid Services (CMS) fueled a total of $1.4 Numerous media and government reports have surfaced since 2021 related to unethical and illegal activity occurring among hundreds of newly licensed hospices, particularly in four hotbed states of California, Arizona, Nevada and Texas.

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Hospice News

JANUARY 10, 2025

Centers for Medicare & Medicaid Services (CMS)] to design and implement effective reforms to address fraud and poor quality providers in the industry. Susan Ponder-Stansel, CEO, Alivia Care A drive towards oversight and reform There will be continued pressure from the trade associations and Congress for [the U.S. Bartness, St.

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Hospice News

OCTOBER 13, 2023

Implementation of the Medicare Advantage hospice carve-in has been challenging for both payers and providers, though a recent analysis indicates that it may get easier over time. Centers for Medicare & Medicaid Services (CMS) commissioned the RAND Corp. Centers for Medicare & Medicaid Services (CMS) commissioned the RAND Corp.

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Hospice News

MARCH 23, 2023

Centers for Medicare & Medicaid Services (CMS) is extending the value-based insurance design demonstration for calendar years 2025 to 2030, including the hospice component. The hospice component of VBID, also called the MA carve-in, launched in 2021 and was originally slated to complete after four years. It makes sense.

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Hospice News

JUNE 14, 2023

Meanwhile, Medicare hospice spending is expected to more than double by 2032. Centers for Medicare & Medicaid Services (CMS) Office of the Actuary also project that health care expenditures will represent 19.6% of the nation’s gross domestic product by the end of that time frame, up from slightly more than 18% in 2021.

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Hospice News

MARCH 4, 2024

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.

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Hospice News

JUNE 27, 2022

Social and economic factors like these drive 40% of health outcomes, according to the Better Medicare Alliance. Health care providers, payers, and other stakeholders are increasingly paying more attention to both social determinants and palliative care, including Medicare and Medicaid. Case in point, the U.S.

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Hospice News

SEPTEMBER 27, 2023

For calendar year 2024, 13 Medicare Advantage Organizations (MAOs) will participate in the program’s hospice component, providing coverage through 78 health plans in 19 states. The hospice portion, often called the Medicare Advantage carve-in, is one component of the larger VBID demonstration that includes providers from across the continuum.

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Hospice News

NOVEMBER 28, 2023

Providers see sustainability and expanded service growth as main draws to participating in the Medicare Advantage hospice carve-in. Centers for Medicare & Medicaid Services (CMS) recent webinar. Hospice utilization in VBID CMS launched the carve-in at the beginning of 2021, and last month issued results of the RAND Corp.’s

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Hospice News

OCTOBER 4, 2022

The Center for Medicare & Medicaid Innovation (CMMI) is developing new reimbursement pathways for palliative care. As part of that process, CMMI is applying elements of its Medicare Care Choices Model (MCCM) demonstration, which ended Dec. 31, 2021, according to a new CMMI white paper. To date, the U.S.

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Hospice News

DECEMBER 12, 2023

Spending by Medicare, hospice’s principal payer, accounted for 21% of the total national expenditures, hitting $944.3 Growth in Medicare spending also dropped to 5.9% Economic patterns also reflect the growing presence of Medicare Advantage. increase in 2021. increase in 2021. In 2021, the growth rate was 11.5%.

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Hospice News

DECEMBER 14, 2022

trillion in 2021, according to a new analysis from the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS). These sources continue to provide funding in 2021, but at much lower levels and in 2020.”. economy in 2021, down from 19.7% billion in 2021. to reach $4.3 of the U.S.

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Hospice News

SEPTEMBER 8, 2023

Over time, Medicare Advantage plans will likely have a greater presence as hospice payers, and now is the time for providers to build relationships those organizations. billion nonprofit Medicare Advantage (MA) organization that covers more than 285,000 members across California, Arizona, Nevada and Texas. SCAN is a $4.3

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Hospice News

AUGUST 15, 2024

The post-Medicare Advantage hospice carve-in landscape could include wider value-based reimbursement avenues in the hospice space, leading providers to pivot into MA payer relationships. You need to be at the table with Medicare Advantage plan negotiations and make yourself known. a hospice and home care consulting company.

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Hospice News

MARCH 8, 2024

Centers for Medicare & Medicaid Services (CMS) has honed in on hospice program integrity through a number of new regulations, including some in the agency’s 2024 hospice final rule. The regulations focused on Medicare enrollment in an effort to stifle unethical or illegal activity in the space.

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Hospice News

NOVEMBER 1, 2023

Centers for Medicare & Medicaid Services (CMS) has finalized its 2024 home health rule, including the implementation of a hospice Special Focus Program (SFP). The final rule forbids any change in majority ownership during the 36 months after initial Medicare enrollment, including acquisitions, stock transactions or mergers.

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Hospice News

SEPTEMBER 30, 2022

In 2021, hospice was a $23 billion industry that made up roughly 20% of the overall U.S. The Center for Medicare & Medicaid Innovation is currently testing coverage of hospice care through Medicare Advantage with the Value-Based Insurance Design (VBID) program. The state of hospice and palliative care markets.

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Hospice News

JANUARY 13, 2023

A key attractor is the potential cost savings associated with risk-based payment systems like Medicare Advantage, in which UnitedHealth Care is of the largest players. billion in Q4 2021. NYSE: HUM), which in 2021 purchased 100% ownership of Kindred at Home for $5.7 1, 2021, with 53 participating health plans.

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Hospice News

MARCH 14, 2024

In Calendar Year 2021, the share of hospice care days with nurse visits in the last seven days of life rose to 63%, up from 62% year over year, according to the National Hospice and Palliative Care Organization (NHPCO). Social worker visits in the last days of life also rose to 9% in 2021, up from 7% in 2020.

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Hospice News

MAY 17, 2024

The court also ordered Akula to repay $42 million in fraudulent Medicare billing claims made between January 2013 and December 2019, which totaled roughly $84 million during that six-year span. The charges included fraudulent claims for physician services and home visits, as well as manipulation of Medicare billing codes.

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Hospice News

MARCH 15, 2024

The Medicare Payment Advisory Commission (MedPAC) has recommended to Congress a freeze on hospice payment increases starting in 2025. The 2021 aggregated Medicare hospice margin was 13.3%, according to MedPAC. More than 49% of Medicare decedents enrolled in hospice care during 2022, up from 47.3% decline from 2018.

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Hospice News

JULY 12, 2024

More than 57,000 people in Illinois elected the Medicare Hospice Benefit in 2021, according to the U.S. Centers for Medicare & Medicaid Services. By 2030, the department projects that seniors will represent 25% of the Illinois population, about 3.6 million people.

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Hospice News

DECEMBER 9, 2022

Often called the MA hospice carve-in , the voluntary demonstration is designed to assess payer and provider performance related to hospice within Medicare Advantage (MA). Centers for Medicare & Medicaid Services (CMS) has indicated that hospices should ensure that their billing staff is familiar with the 2023 modifications.

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Hospice News

JANUARY 12, 2024

The Medicare Payment Advisory Commission (MedPAC) has voted to recommend a freeze on hospice payment increases starting in 2025. Centers for Medicare & Medicaid Services (CMS). Centers for Medicare & Medicaid Services (CMS). The 2021 aggregated Medicare hospice margin was 13.3%, according to MedPAC.

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Hospice News

MARCH 24, 2023

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. Originally set to run between 2021 and 2024, CMS indicated yesterday that it would invest five additional years in the demonstration.

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