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Hospice Medical Director Receives 50-Month Prison Sentence for $150M Fraud

Hospice News

A federal judge has sentenced Jesus Virlar-Cadena, formerly a medical director for the Texas-based hospice company Merida Group, to 50 months in prison for his role in a $152 million scheme. The Texas Medical Board suspended his medical license in 2019, when he pleaded guilty to the fraud charges.

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The ISNP Opportunity for Hospice Providers

Hospice News

Hospice providers can collaborate with institutional special needs Medicare Advantage plans (ISNP) to reach patients who reside in long-term care facilities. An ISNP is a Medicare Advantage plan for those living in a nursing home. The payment model aligns with the general Medicare Advantage rubric.

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CMS 2025 Proposed Rule Signals Changes to Quality Measurement, Omits Program Integrity Actions

Hospice News

Centers for Medicare & Medicaid Services (CMS) proposed a 2.6% billion in annual savings for Medicare, which underscores the critical importance of investing in hospice to ensure continued beneficiary access to quality end-of-life care.” Hospice care saves Medicare roughly $3.5 In a proposed rule released yesterday, the U.S.

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U.S. Health Care Expenditures to Reach $7.1 Trillion by 2031; Hospice Spending to Double by 2032

Hospice News

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% However, the annual Medicare Trustees Report for 2023 provides a more detailed look at hospice spending.

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How Hospice, Behavioral Health May Cross Paths

Hospice News

“I know how helpless physicians and nurse practitioners can feel when confronted with patients struggling with dementia. Not only problems related to diagnosis and treatment, but also the myriad challenges that arise in the social realm,” Hospice of the Valley Executive Medical Director Ned Stolzberg told local news.

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3 Palliative Care Providers to Watch

Hospice News

Smith said Prospero’s global measure of success is providing more days for patients at home, rather than keeping them in hospitals, nursing homes or rehab facilities. Reimbursement for palliative care in fee-for-service Medicare currently only covers physician or nurse practitioner services.

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Hospice News’ Top 10 Stories of 2024

Hospice News

Centers for Medicare & Medicaid Services (CMS) ramped up auditing activity in the space while also sunsetting the hospice component of its value-based insurance design (VBID) model demonstration ahead of its initial expiration. The financial incentives in Medicare Advantage are designed to reduce overutilization, researchers indicated.

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