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Hospices have grown increasingly frustrated by fraudulent operators in the space and how their activities affect legitimate operators’ financial health. This is the second of a two-part Hospice News series that explores how fraud, waste and abuse in the hospice space could create headwinds for the industry at large.
Carol Miller (R-West Virginia) and Jared Golden (D-Maine) have reintroduced the Hospice Recertification Flexibility Act. If enacted, the bill would allow hospices to conduct face-to-face recertification visits via telehealth. Hospicecare exists to provide comfort and compassion during heartbreaking times.
Centers for Medicare & Medicaid Services (CMS) has issued a memo to accreditation bodies and state agencies advising surveyors to watch out for potential hospice fraud. These actions were spurred by a rash of fraudulent hospices that have emerged primarily in California, Texas, Nevada and Arizona.
Texas-based New Day Healthcare LLC has announced its acquisition of Good Samaritan Society’s hospice operations in its home state. The transaction includes Good Samaritans hospice assets in El Paso, Texas, expanding New Days existing presence in that market. Hospice utilization rates hovered at 49.1% Scott Herman.
Congress has passed the Full-Year Continuing Appropriations and Extensions Act 2025 (FY2025) , which allowed for continuation of several public health, Medicare and Medicaid authorities and programs. Congress must prioritize permanent protections to put patients first and unlock the full potential of telehealth.
Florida-based VITAS Healthcare is anticipating fruitful hospice growth on its horizon. NYSE: CHE) subsidiary has seen record-highs in patient census volumes and is ramping up strategic plans to expand its geographic footprint across its home state. The hospices average daily census volume reached 22,179 patients in Q4, a 14.6%
The hospice industry is undergoing a transformative period of rising demand and regulatory changes. This is according to Scott Levy, chief government affairs officer at National Alliance for Care at Home (the Alliance). working hand-in-glove on policy issues with colleagues across the home health and hospice industries.
Rising demand for end-of-life care is pushing hospice growth opportunities to the forefront in value-based reimbursement. More payers in this arena are increasingly recognizing the depth of potential beneficial outcomes when it comes to collaborative hospice partnerships. billion in 2022, Medicare (MedPAC) reported.
Staff development, technology adoption and steady organic growth are top priorities for Family Hospice CEO Charles Hall as he takes the helm at that organization. Family Hospice was founded by Jack Draughon and Mark Kempsey three years ago. My father had been in hospice. Army officer.
The Pennant Group has been quietly building palliative care programs driven by its local leaders with support from the corporate offices Service Center. Pennant is the holding company for a group of independent hospice, home health and senior living providers located across 13 states.
Scott Herman, CEO of New Day Healthcare, told Hospice News in an email. Having expanded PCS services in Houston allows us to engage a full home care continuum, furthering our longitudinal care strategy. Similar to national demographic trends, a growing aging population is driving demand for hospice in Texas.
The MedicareHospice Benefit is ripe for change nearly four decades after its establishment, but moving the needle will include a heavy lift around evolving regulations. This is according to Bill Dombi, president of the National Association for Home Care & Hospice (NAHC). But hospice has moved into a new era.
Bristol Hospice has acquired Mississippi-based Mid-Delta Hospice, a move that marked its entry into the state. The decision to launch services in a new state came with growing recognition around rising demand for home health and hospicecare, according to Bristol Hospice CEO and President Alex Mauricio.
They want concierge care, and thats exactly what were providinga high level of personalized, in-home support for those with chronic medical conditions. The program operates under WesleyLifes hospice umbrella, with a dedicated nurse practitioner and social worker leading patientcare.
While they may have the clinical insight to deliver these services, they may have limited experience negotiating contracts specifically for palliative care, which can be particularly challenging in the absence of a standardized care model and payment structure, he said. “At
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. We are a health care provider.
Hospice reimbursement trends influence palliative care payment and delivery. Among the significant changes coming this year is the end of the hospice component of the value-based insurance design (VBID) model, as of Dec. Alivia Supportive Care launched in 2020 as the nonprofit’s home-based palliative care service line.
The mission and function of the Medicare program have evolved over time, and the agency that runs it also may need to adapt to the new ways that health care organizations are doing business, according to SCAN Group CEO Dr. Sachin Jain. billion nonprofit Medicare Advantage (MA) organization that covers more than 270,000 members.
Members of Congress are raising questions about the continued Medicare certification for new hospices in areas rife with fraud. Though he pledged more detailed responses at a later date, Becerra told lawmakers that CMS is certifying hospices in markets where there is a need identified in the community. “I
A coalition of hospice, home health and palliative care organizations has called on Congress to extend temporary telehealth flexibilities implemented during the pandemic. Doing so would help ensure continued access to quality care among vulnerable patient populations, according to the organizations.
When it comes to communication and quality of care for Black patients, recent data reinforces the notion that hospices have room to grow. The core of these issues largely rests in the hands of health care providers, according to researcher Brittany Chambers, director of health equity and special initiatives at CAPC.
Centers for Medicare & Medicaid Services (CMS) has been gradually implementing changes to the hospice survey process and enforcement remedies, including civil monetary penalties in some instances. The monetary penalties were among seven enforcement remedies introduced through the HOSPICE Act and subsequent CMS rules.
Fraudulent hospices continue to proliferate, and some may be moving between states to escape regulators. Beginning in 2021, numerous reports emerged of unethical or illegal practices among hundreds of newly licensed hospices, particularly among new companies popping up in California, Texas, Nevada and Arizona.
Centers for Medicare & Medicaid Services (CMS) is insufficient to support hospicepatients’ care needs, a major industry group said. CMS earlier this month released its 2024 hospice proposed rule , which included the 2.8% proposed rate increase for hospices is not enough to support the carehospices provide.
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.
The Dallas-based home health and hospice provider Intrepid USA will pay $3.85 The company was accused of enrolling patients for both home health and hospice services who were not eligible. The company was accused of enrolling patients for both home health and hospice services who were not eligible.
Patient data protection and telehealth compliance are key pieces for hospices to bear in mind when navigating technology partnerships in a post-pandemic regulatory landscape. Hospices are facing regulatory concerns since the COVID-19 public health emergency ended (PHE) on May 11 that have centered around telehealth.
An overwhelming majority of hospice providers have seen costs of patientcare rise 3% to 10% since 2019, and many expect further increases next year. This is prompting calls for Medicare to reconsider proposed 2023 reimbursement rates. . The hospice advocacy group NHPCO is now asking the U.S.
The most recent iteration of HospiceCare Accountability, Reform and Enforcement (HospiceCARE) Act, currently in a discussion draft phase, could have some unintended consequences in the future of end-of-life care delivery. Developed by U.S. Blumenaur’s office and members of the House Ways and Means Committee.
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.
The forthcoming expiration of telehealth flexibilities implemented during the pandemic could have a devastating impact on vulnerable populations, including those receiving hospice or palliative care. This is according to Dr. Holly Yang, board president of the American Academy of Hospice and Palliative Medicine (AAHPM).
The hospice and senior care provider Helios Care is partnering with the integrated health system Bassett Healthcare Network to bring more extensive access to hospice and palliative care to patients in central New York. Centers for Medicare & Medicaid Services (CMS).
Centers for Medicare & Medicaid Services (CMS) is considering administrative action against 400 hospices, which could include revocation of their Medicare certification. The agency has been mobilizing against hospice fraud this year.
Hospices, in aggregate, are showing improvement on the quality measure for visits in the last days of life. The number of registered nurse and social worker visits during a patient’s final week is one of the seven quality measures that CMS uses to evaluate providers. Through the predictive analytics data, hospicepatients at St.
Hospices seeking to gauge the potential impact of new regulatory actions in the space can look to their counterparts in the home health field. We then started seeing the greater degree of impact,” Dombi told Hospice News. CMS is no doubt hoping for similar results for the MedicareHospice Benefit. told Hospice News.
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.
Hospice providers and stakeholders are carefully examining the proposed changes included in the recently introduced HospiceCare Accountability, Reform, and Enforcement (HospiceCARE) Act as the bill begins its journey through the legislative process. this summer. “It
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.
The four largest hospice industry organizations have been working to present a united front to address widespread program integrity issues. A large contingent of these companies were established with the purpose of selling the license at a profit, with little concern for patientcare. This prompted the U.S.
The 2024 final hospice payment rule included a modest payment increase for general inpatient care (GIP) at a time when regulators are zeroing in on increased utilization and longer stays. Centers for Medicare & Medicaid Services (CMS) included in the rule a 1.031% increase to hospice GIP services.
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.
As more hospices engage with Medicare Advantage (MA) plans, they may be able to learn from the experiences of some home health providers. Historically, MA has not covered hospice. This meant lower reimbursement, as MA plans often negotiate for payments that are lower than those in traditional Medicare.
Understanding payer priorities in defining the scope of quality is vital for hospices to thrive not only in traditional Medicare, but also in today’s value-based reimbursement climate. The nitty gritty details of data tracking and management matter when it comes to ensuring both a healthy bottom line and quality patientcare.
Croix Hospice has expanded in Wisconsin, opening its 14th location in the state. “We have been serving the state of Wisconsin for many years, continuing our long tradition of exceptional patientcare,” St. . Croix Hospice CEO Heath Bartness said in a press release. ” The post St.
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