Lawmakers Ask DOJ, FTC to Examine Optum’s Amedisys Transaction

Sen. Elizabeth Warren (D-Massachusetts) and Rep. Pramila Jayapal (D-Washington) have called on the U.S. Justice Department (DOJ) and the Federal Trade Commission (FTC) to “scrutinize” the pending acquisition of Amedisys (NASDAQ: AMED) by Optum Health. Optum, a subsidiary of UnitedHealth Group (NYSE: UHN), in June penned its agreement to acquire Amedisys in an all-cash transaction […]

Houston Hospice Makes Inpatient Unit Available to Other Operators

Houston Hospice is opening up its inpatient unit for use by other providers. Other hospices will soon be able to admit patients to the company’s unit in the Texas Medical Center in Houston. They will be able to coordinate with Houston Hospice and deliver General Inpatient Care (GIP), helping to avoid hospital readmissions. “Many of […]

Understanding CMS’ Civil Monetary Penalties for Hospices

The U.S. 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. Congress approved the survey changes and enforcement actions through the Consolidated Appropriations Act of 2021, which incorporated language from the Helping Our Senior Population in Comfort […]

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

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 court also ordered Virlar-Cadena to pay $9 million in restitution and $9 million in forfeiture. The Texas Medical Board suspended his medical license […]

Where Palliative Care Fits into CMMI’s GUIDE Model for Dementia Care

Palliative care providers may be uniquely positioned to develop partnerships that support patients through the new Guiding an Improved Dementia Experience (GUIDE) Model recently unveiled by the Center for Medicare & Medicaid Innovation. While the program is not a palliative care model, those providers are well-suited to deliver the kind of care that GUIDE outlines. […]

Future Leader: Amy Rose, Product Director, Palliative Care Solutions, Axxess

The Future Leaders Awards program is brought to you in partnership with Homecare Homebase. The program is designed to recognize up-and-coming industry members who are shaping the next decade of home health, hospice care, senior housing, skilled nursing, and behavioral health. To see this year’s Future Leaders, visit https://futureleaders.agingmedia.com/. Amy Rose, product director, Palliative Care […]

Health Plan Participation in Hospice VBID to Shrink in 2024

Health plan participation in the hospice component of the value-based insurance design model (VBID) will fall in 2024. For calendar year 2024, 13 Medicare Advantage Organizations (MAOs) will participate in the program’s hospice component, providing coverage through 78 health plans in 19 states. In 2023, 15 MAOs participated in hospice VBID, including 119 health plans […]