Hospice News

NOVEMBER 16, 2023

Medicare fee-for-service programs made $31.23 billion in improper payments during 2023, though a smaller proportion of those dollars went to hospices than in years prior. Hospices received nearly 5.4% of improper payments from Medicare in 2023, down from 12% in 2022, according to a new report from the U.S.

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Medicare Hospice Document 2023 264

Hospice News

SEPTEMBER 15, 2023

For the time being, Medicare Advantage may be providers’ best bet for palliative care reimbursement. Centers for Medicare & Medicaid Services (CMS) also allows Medicare Advantage plans to cover palliative care as a supplemental benefit. She is also co-founder of the company’s hospice and home health service segment.

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Hospice News

AUGUST 17, 2022

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.

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Hospice News

AUGUST 16, 2023

Medicare Advantage plans are connecting the dots between quality scores and care delivery costs. When choosing a hospice to work with, payers in the Medicare Advantage (MA) realm zero in on providers’ quality scores and its patient population growth potential, according to Frontpoint Healthcare CEO Brent Korte.

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Medicare Hospice Document 2022 246

Hospice News

SEPTEMBER 15, 2022

A coalition of hospice and palliative care industry groups has urged lawmakers to make billing codes for telehealth available on Medicare hospice claim forms. Centers for Medicare & Medicaid Services (CMS) to develop and implement Healthcare Common Procedure Coding System (HCPCS) codes or modifiers for telehealth visits. .

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Hospice News

APRIL 3, 2025

AccentCare is primed for further hospice growth, with both health system joint ventures and de novo activity as twin cornerstones of its strategy. Dallas-headquartered AccentCare provides hospice, home health, personal and palliative care across 32 states and in the District of Columbia.

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2025 2019 Palliative care Palliate 241

Hospice News

APRIL 9, 2025

Youre in it and just trying to navigate a complex system, whether its dealing with Medicare or Medicaid, or your health insurance, or knowing what nonprofits in your area might be able to provide, how friends and neighbors and family members can support you. Theres not a lot of national conversation about where we are and the support we have.

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Hospice News

JUNE 14, 2024

Hospice providers are navigating a minefield in today’s regulatory environment to avoid getting caught up in the mix of fraudulent activity in the space. Program integrity continues to be tragically a problem with hospice,” Harrison told Hospice News. “It’s It’s a concern that continues to tarnish hospice.

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Hospice Document Palliative care Medicare 288

Hospice News

OCTOBER 27, 2023

As audits proliferate in the hospice space, providers can benefit from understanding the appeals process. Hospices are increasingly wading through an alphabet soup of auditing activity in the industry. Centers for Medicare & Medicaid Services (CMS) considers to be unusual.

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Hospice Document Medicare Palliative care 290

Hospice News

JULY 30, 2024

Centers for Medicare & Medicaid Services (CMS) has unveiled its final 2025 hospice rule, which includes a 2.9% The increase represents an estimated $790 million rise in total hospice payments compared to Fiscal Year (FY) 2024. The finalized hospice cap amount for FY 2025 is $34,465.34, up from $33,494.01

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2025 Hospice 2024 Medicare 306

Hospice News

MARCH 26, 2025

Todays hospice landscape is reaching a pivotal point of evolutionary growth that has come with increased oversight as regulators seek to curb fraudulent activity in the space, according to Bill Dombi, senior counsel for the law firm Arnall Golden Gregory (AGG). What are the leading legal concerns facing hospice providers right now?

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Hospice Care at home Document Medicare 113

Hospice News

SEPTEMBER 20, 2024

Unified Program Integrity Contractor (UPIC) auditors are taking a sharper look at nursing home room-and-board for hospice patients. Hospices have increasingly faced more regulatory scrutiny in recent years amid rising program integrity concerns, including ramped up UPIC audits , among various others.

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Hospice Medicare Document Nursing home 290

Hospice News

JUNE 4, 2024

When hospice providers are being investigated not just by CMS but the FBI, the stakes for compliance are higher than ever. In May of 2024, the federal law enforcement agency placed its spotlight on the rising number of complaints about hospice fraud, in which hospices participate in signing up seniors for care without the seniors’ knowledge.

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Homecare Hospice Document 2024 264

Hospice News

JANUARY 3, 2023

Kathy Hochul (D) has vetoed legislation that would have effectively banned new, for-profit hospices in the state. It would have prohibited the establishment of for-profit hospices in New York state and forbid current for-profit operators from increasing capacity. . Centers for Medicare & Medicaid Services (CMS).

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Hospice Medicare Palliative care Palliate 295

Hospice News

APRIL 12, 2024

Centers for Medicare & Medicaid Services’ (CMS) proposed 2025 hospice rule contains clarifications on which physicians may certify patients for hospice enrollment. Clarification from CMS in these areas will be helpful to hospices, physicians and those reviewing hospice records for compliance.”

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2025 Medical director Hospice Document 279

Hospice News

APRIL 25, 2024

As more technology seeps into the health care world, some hospices are leveraging new systems to improve compliance, standardize processes and anticipate patients’ needs. Providers are increasingly relying on systems designed to improve clinical documentation, performance on quality measures and to guide business decisions.

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Hospice Document Medicare 264

Hospice News

JUNE 9, 2022

Unified Program Integrity Contractor (UPIC) audits are on the rise among hospices, with some seeing penalties like reimbursement suspension or repayments. Centers for Medicare & Medicaid Services (CMS) contracts UPIC entities to conduct investigations and audits related to potential fraud, waste or abuse. Department of Justice.

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Hospice Document Medicare 290

Hospice News

JULY 7, 2023

Hospices need to have solid documentation to demonstrate a patient’s need for general inpatient care (GIP) as regulatory oversight zeroes in on those services. I have seen increasing GIP hospice audits in recent years. It is reasonable for hospices to expect that long length GIP stays will be under scrutiny.”

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Hospice Document Medicare 2024 246

Hospice News

JULY 17, 2023

Centers for Medicare & Medicaid Services (CMS) is conducting a small pilot program for post-payment reviews of hospice stays that exceed 90 days. CMS internal data has identified a potential area of vulnerability beginning with the second benefit period, or 91st day in hospice,” Noridian indicated in an announcement. “CMS

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Hospice News

JULY 17, 2023

Fraud, waste and abuse issues that have percolated in the hospice space have put providers up against some regulatory walls. Bad actors in the hospice space can cost the nation’s health care system millions in fraudulent billing practices and also hinder access to care among terminally ill patients.

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Hospice Document Home healthcare Medicare 246

Hospice News

JULY 12, 2024

The forthcoming Hospice Care Accountability, Reform and Enforcement (Hospice CARE) Act from U.S. Blumenauer announced the bill in June at the Hospice News Elevate conference in Washington D.C. There’s evidence that people who take advantage of hospice care delivered properly, actually have a higher quality of life.

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Hospice News

NOVEMBER 2, 2023

Greater transparency in staff evaluation processes and increased education will be keys to navigating a range of hospice compliance challenges in a post-pandemic landscape. Transparency around hospice staffing and ownership is a large focus of program integrity efforts among regulators, Piland stated. On Wednesday, the U.S.

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2024 Hospice Medicare Document 263

Hospice News

JUNE 17, 2022

Patient eligibility is a frequent focus of hospice audits, but it can be a challenging point for providers to prove. Aside from strong documentation, insight from hospice physicians around patient conditions is a key defense in appealing audits, experts say. Centers for Medicare & Medicaid Services (CMS) or other agencies.

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Document Hospice Medicare 2023 246

Hospice News

FEBRUARY 23, 2023

Hospices are seeking greater clarity on updated Medicare rules that allow hospices to document a broader range of chaplain services on claims. While the revisions do not impact reimbursement, they allow hospice providers to track and report the duration, frequency and extent of the spiritual care patients receive.

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Chaplain Hospice chaplaincy Hospice Document 264

Hospice News

FEBRUARY 22, 2024

Hospice personnel could face criminal charges in instances of suspected fraud, waste and abuse. The regulatory stakes are high for hospice providers when it comes to False Claims Act (FCA) violations, according to Jonathan Porter, partner at the law firm Husch Blackwell. Criminal] trials are rare, but the [U.S.]

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Hospice Medicare Document 2024 274

Hospice News

JANUARY 17, 2024

Hospice providers, industry groups and other stakeholders recently penned a letter urging Congress to improve payment infrastructures that would increase access to end-of-life care among rural populations. For some rural areas, they’re not seen as financially feasible or sustainable to larger programs,” Kuhlman told Hospice News. “So,

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Hospice Palliative care End-of-life care 2008 290

Hospice News

SEPTEMBER 8, 2023

Both opportunities and challenges exist for hospice providers as regulators zero in on program integrity. Hospices stand to grow their census by taking on patients left behind by “bad actors” in certain markets. Widespread reports of fraud and abuse in hospice have led to intensified regulatory oversight during 2023.

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Hospice Document 2024 Registered Nurse 264

Hospice News

AUGUST 25, 2022

Buyers in a hot hospice M&A market are bringing compliance under a microscope as regulators keep a tight watch. All hospice transactions undergo some type of compliance review. But there’s nothing routine about these reviews in today’s current hospice regulatory environment. This includes the U.S.

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Hospice News

JULY 21, 2023

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.

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Hospice 2019 Document Medicare 246

Hospice News

AUGUST 24, 2023

Increased hospice oversight aimed at curbing fraud in the industry could come with a mixed bag of financial and operational impacts for providers. Centers for Medicare & Medicaid Services (CMS) has honed in on hospice program integrity, rolling out a swath of new measures to reduce fraud, waste and abuse in the space.

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Hospice Document 2012 2016 246

Hospice News

OCTOBER 28, 2022

Building in redundancies around patient admission processes may help hospices withstand regulatory scrutiny, according to legal experts in the space. Patient eligibility is a frequent focus of hospice audits as regulators sharpen oversight in the industry. Centers for Medicare & Medicaid Services (CMS) and the U.S.

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Hospice News

FEBRUARY 26, 2024

Hospice operators in 2024 are navigating a rapidly transforming environment. The prior three years have laid the groundwork for change, particularly in the regulatory space as well as gradual migration towards value-based reimbursement and in tandem, the proliferation of business lines beyond hospice.

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Hospice News

APRIL 6, 2023

Two hospice fraud cases are moving forward in California and Arizona, states that some stakeholders consider to be potential hotbeds of malfeasance in the space. False Claims Act violations in California San Gabriel Hospice & Palliative Care submitted roughly $3.67 million in false and fraudulent claims to Medicare, of which $3.18

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2016 Hospice Document Medicare 246

Hospice News

JANUARY 2, 2024

As auditing activity by regulators continues to spike, hospices need to know how to conduct internal investigations to identify any potential improper payments. Centers for Medicare & Medicaid Services (CMS) actively works to recoup payments that it deems improper. Medicare fee-for-service programs made $31.23

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Medicare Hospice Document 2023 130

Hospice News

NOVEMBER 27, 2022

Regulatory attention heating up in the hospice industry could be impacting buyers’ decisions/how buyers move forward with mergers and acquisitions in the space. The nuances involved in the regulatory environment around hospice can be difficult to navigate for private equity and venture capital investors that are new to the industry.

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Hospice Medicare Document 2019 246

Hospice News

SEPTEMBER 2, 2022

Closing these gaps is a rising priority in payment model demonstrations by the Center for Medicare & Medicaid Innovation (CMMI). The work being done at CMMI has a direct impact on hospice providers. Centers for Medicare & Medicaid Services (CMS). The center is a component of the U.S.

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Hospice News

AUGUST 7, 2023

As regulatory agencies crack down on hospice spending, providers can benefit from recognizing the links between revenue cycle management and compliance. Centers for Medicare & Medicaid Services (CMS) has ramped up auditing activity tied to longer stays and more expensive levels of care such as GIP. For example, the U.S.

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Hospice Medicare Document Home care 246