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Centers for Medicare & Medicaid Services (CMS) recently elaborated on its plans to expand public education campaigns designed to help protect hospice beneficiaries from fraudulent actors in the space. Program integrity concerns have heated up in the hospice industry.
Centers for Medicare & Medicaid Services (CMS) in response to fraud allegations that have resulted in licensure and billing privilege revocation. Shaarawy provides internal and family medicine, palliative care and hospice services and operates a private practice in Canoga Park, California. court documents stated.
Mahogany Home Health and Hospice recently launched services in southwestern Ohio. The new hospice startup is the first Black-owned hospice and home health organization statewide with a drive to improve utilization among underserved populations. Couzens has also held hospice chaplain roles at St.
The MedicareHospice Benefit could use an “upgrade” to ensure greater flexibility that may be necessary to fully support patients’ needs. Centers for Medicare & Medicaid Services (CMS) should consider is retiring the six-month terminal prognosis requirement and allowing for some concurrent care, Wallace and Wladkowski indicated.
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.
Financial volatility across the health system presents a substantial risk to palliative care teams, because there are no requirements that health systems or plans provide palliative care (with some specific exceptions). Centers for Medicare and Medicaid Services (CMS) approved a State Plan Amendment (SPA).
Careful management of the hospice aggregate cap is key to providers’ sustainability as regulatory scrutiny continues to heat up. The cap is designed to prevent overuse of hospice, put controls on Medicare spending and foster greater access to care among patients. For Fiscal Year 2024, the U.S. In 2025, this will rise to $34,465.
Centers for Medicare & Medicaid Services (CMS) is insufficient to support hospice patients’ 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 care hospices provide. “The
Anti-kickback and health care fraud cases have recently cropped up in two southern states, with hospice personnel facing millions in fines and one owner facing imprisonment for their involvement. David Lovell, its founder and owner, launched the for-profit hospice in 2010, and the enterprise became Medicare-certified in 2012.
Errors or other inconsistencies with the payment cap can have significant consequences for providers, and sales and marketing staff can help hospices achieve a healthy balance. The cap is designed to prevent overuse of hospice, put controls on Medicare spending and foster greater access to care among patients.
Kristal Glover-Wing, the former owner of Louisiana-based Angel Care Hospice, has been found guilty of one count of conspiracy to commit health care fraud and three counts of health care fraud. Justice Department, Angel Care enrolled 24 patients in hospice between 2009 through 2017 who did not meet Medicare eligibility requirements.
Without assistance or relief, these difficulties can impede access to hospice. Research has shown that patients who are faced with end-of-life decisions may be less likely to choose hospice unless they have a network of friends or family who can serve as home caregivers. This only worsened during COVID-19.
A new hospice nursing recruitment effort has launched in the New England region after being stalled by the pandemic. The recruitment initiative is the fruit of a collaboration between Visiting Nurse and Hospice for Vermont and New Hampshire (VNH) and the Home Care, Hospice & Palliative Care Alliance of New Hampshire (the Alliance).
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
Hospices, in aggregate, are showing improvement on the quality measure for visits in the last days of life. 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).
Hospices are operating in a changing competitive environment, and some are rolling with the punches better than others. With these trends stirring the pot, hospices must find ways to adapt, according to Kara Justis, vice president of strategic consulting for Trella Health. Several forces are driving the change.
Though evidence shows that longer hospice stays reduce costs, providers are still walking a regulatory tightrope. On one hand, longer hospice stays can lead to improved patient and family satisfaction and greater cost saving opportunities. Are you in an outlier scenario with your data that Medicare contractors are looking at?
Documentation errors and a fragmented health system pose the greatest risks for adverse drug events among hospices. McPherson also serves on the board of the American Academy of Hospice and Palliative Medicine (AAHPM). They also need to know which side effects are more concerning and should prompt a call to the hospice.”
The four largest hospice industry organizations have been working to present a united front to address widespread program integrity issues. In some instances, multiple hospices have been operating out of the same address without a corresponding increase in the population of eligible patients. This prompted the U.S.
Hospice provider Agape Care Group has acquired GHC Hospice for an undisclosed sum, furthering the company’s goal of multistate expansion through the Southeast. We’ve been laser focused in the Southeast over the last few years and do feel like it gives us the most near-term upside,” Agape CEO TroyYarborough previously told Hospice News.
In this Voices interview, Hospice News sits down with Deanna Heath, VP of Hospice, KanTime, to talk about the potential impact of the Value-based Insurance Design (VBID) model on today’s hospice landscape. Hospice News: What career experiences do you most draw from, in your role today?
As the hospice landscape shifts and hospice care is delivered more widely, another care type has made entry into the conversation: palliative care. The shift does present challenges, however. Based upon the request of a hospice customer, Axxess began to develop a palliative care-specific technology platform in 2021.
Program integrity and an onslaught of audits are top of mind for many hospice providers in 2024. The organizations earlier this year presented their findings , published today, to members of Congress and the U.S. Centers for Medicare & Medicaid Services (CMS). In addition to those my Medicare Contractors, last year the U.S.
Hospice providers and stakeholders are carefully examining the proposed changes included in the recently introduced Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act as the bill begins its journey through the legislative process. Earl Blumenauer (D-Oregon) introduced the Hospice CARE Act last month.
The home health and hospice provider last summer placed a focus on expanding its Medicare Advantage (MA) business, forming a payer innovation team focused on strengthening Enhabit’s value proposition to health plans. We’ve faced challenges as a result of our previous lack of work with Medicare Advantage plans.
SCAN Health Plan is among the Medicare Advantage (MA) payers entering the hospice component of the value-based insurance design (VBID) payment demonstration in 2023. The four-year program — often called the Medicare Advantage hospice carve-in — launched Jan. Hospice VBID enters its third year in 2023.
Most hospices are sliding into 2023 between a rock and a hard place, beset by headwinds, labor shortages and questions with no easy answers. Government oversight of hospice providers will tighten during 2023. Hospices have faced ever-intensifying scrutiny from regulators in recent years. Be ready for regulation.
If you were to write a book about hospice in 2023, what would you call it? To help answer that question, Hospice News asked the CEOs of eight providers how they would title a book about the state of the field today. Croix Hospice, AccentCare, Chapters Health System, Alivia Care, Enhabit, Inc., We want to make a difference.
Primary care company CareConnectMD is building a network of hospice providers following a $25 million investment round last month. A key part of the California-based company’s growth strategy is to bolster the number of hospices in its preferred provider network, according to Founder and CEO Kim Phan. “We
A group of 17 Illinois health care organizations is collaborating to expand access to home-based primary care, including a number of hospice and palliative care providers. million seniors who reside in Illinois are 85 or older, and 40% of Medicare beneficiaries in the state have four or more chronic conditions, according to HCCI.
The 2025 proposed hospice rule is raising some questions along with payment rates. Centers for Medicare & Medicaid Services (CMS) proposed a 2.6% increase in hospice per diems for 2025. We know that hospice care has demonstrated $3.5 We know that hospice care has demonstrated $3.5
Illinois-headquartered Unity Hospice & Palliative Care has expanded to Houston, Texas, following its acquisition of an existing license in that market. This expansion coincides with Unity’s 30 th anniversary as a premier hospice and palliative care organization,” Unity owner Michael Klein told Hospice News in an email. “As
Hospice program integrity has been in the spotlight for at least the past two years, often with high financial stakes for providers. Unified Program Integrity Contractor (UPIC) and Targeted Probe and Educate (TPE) audits are designed to key regulatory safeguards against bad actors in the hospice industry. Stakes around UPICs The U.S.
NYSE: CHE), has opened its first hospice house in Orange County, California, currently the only such facility in that region. More patients elect hospice in California than in any other state. Centers for Medicare & Medicaid Services (CMS). VITAS Healthcare, a subsidiary of Chemed Corp. Census Bureau. year-over-year.
In 2022, the hospice community laid the groundwork for a transformational 2023. Centers for Medicare & Medicaid Services (CMS) developed new approaches for enforcing hospice regulations that will become effective on Jan. The following are the most-read Hospice News articles of 2022. #1
Arizona-based Stoneridge Hospice launched services in 2020 with an aim to address a swelling aging population’s growing need for end-of-life care. Stoneridge Hospice provides home-based hospice and also contracts with other providers to offer facility-based services. Stoneridge Hospice launched in 2020.
As regulators turn their eyes toward hospice program integrity, Community Healthcare of Texas CEO Viki Jingle has seen first-hand the “heartbreaking disservice” that families experience due to unethical practices. We do see a tremendous influx of for-profit, third-party investors coming into the hospice space here in Texas.
While some palliative care programs mirror the hospice model, more operators are working to tailor their services to patients’ specific needs, with varying intensity. Payment streams for palliative care, most palliative programs are relying on a combination of Medicare Part B and grants and fundraising,” Schramm said.
Recent research from Rutgers University-New Brunswick in New Jersey has revealed gaps in hospice referrals and palliative care consultations among underserved patient populations in the state. Diversity in population can yield diverse presentations of symptoms,” Kozlov said. were Hispanic; 1.8% were Asian; and only 0.4%
This strategy presents a vision, along with recommendations for achieving it. The stress and financial burden of caregiving can be a barrier to hospice utilization. Terminally ill patients who lack care from family or friends are often less likely to choose hospice, a 2020 study found.
Patients with ovarian cancer who have received palliative care had fewer hospital readmissions compared to others, according to a recent study presented at the 2023 Annual Meeting on Women’s Cancer from the Society of Gynecologic Oncology (SGO) in Tampa, Florida. Both of those findings were significant as well.”
As lawmakers wrestle with necessary improvements to hospice program integrity, they should seek input from the professionals who provide that care, Dr. Holly Yang, incoming board president of the American Academy of Hospice and Palliative Medicine (AAHPM) told Hospice News. And I think that we don’t need to do that alone.
While they offer an alternative to home-based services, they present their own unique benefits and challenges. One of the agencies that uses the clinic model is Hospice of Northwest Ohio, which serves both Ohio and Michigan. First, the clinic-based model presents challenges in its need for physical space and the associated costs.
Centers for Medicare & Medicaid Services’ (CMS) review and appeals process, according to CEO Greg Hagfors. The case has significance for hospice providers nationwide as CMS and its contractors continue to ramp up audits. OIG, on behalf of CMS, informed the hospice that it would be audited in a May 2018 letter.
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