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Medicare Making Fewer Improper Payments to Hospices

Hospice News

Medicare fee-for-service programs made $31.23 of improper payments from Medicare in 2023, down from 12% in 2022, according to a new report from the U.S. The leading cause of these payments were inaccurate or incomplete documentation. The post Medicare Making Fewer Improper Payments to Hospices appeared first on Hospice News.

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The Role of Medicare Advantage in Growing Palliative Care Services

Hospice News

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. This year, the number of MA plans swelled to 3,998 nationwide, up 6% from 2022.

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Medicare Made $190M in Improper Hospice Payments to Hospitals

Hospice News

Medicare made an estimated $190 million in improper payments to acute-care hospitals for outpatient hospice services between 2017 and 2021. Our medical reviewer found that Medicare paid acute-care hospitals for outpatient services that palliated or managed hospice enrollees’ terminal illnesses and related conditions,” the OIG report stated.

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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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Quality Data, Cost Control: Hospices’ ‘True North’ in Medicare Advantage

Hospice News

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

Hospice News

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. Between 2016 to 2019, Medicare payouts for ACP totaled more than $340 million, OIG reported.

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HSPN ELEVATE: The Common Thread Linking Documentation, Satisfaction, and Revenue Protection

Hospice News

Hospice News: Today we will talk about threads of clinical documentation and satisfaction and also revenue protection. Here’s an area that you missed from a documentation perspective where you could get dinged by CMS for not documenting it, either this element or this way.” One example is a CTI. They love doing it.

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