CMS Proceeding on New Hospice Quality Measure Development

The U.S. Centers for Medicare & Medicaid Services (CMS) is developing two new claims-based quality measures for hospices, to track avoidable transitions from hospice care as well as access to levels of hospice care. CMS does not require hospices to collect or submit data on claims-based measures. The agency itself assembles the data based on […]

MA Carve-In Could Forego 6-Month Prognosis Rule for Hospice

Medicare Advantage plans would not necessarily be bound by Medicare’s six-month terminal prognosis requirement under a forthcoming hospice carve-in. Medicare Advantage plans are offered by private insurance companies approved by CMS, and include HMO, PPO, and fee-for-service plans among other options. The program represents an integrated care model that is designed to promote coordination of […]

New Jersey Enacts Law to Expand Palliative Care

New Jersey has joined a growing list of states that are establishing laws to advance palliative care. Gov. Phil Murphy (D) has signed a bill to create a state advisory council on palliative care and quality of life. The new law also includes provisions for a hospice and palliative care access program to expand public […]

CMS Revises Immediate Jeopardy Citation Process

The U.S. Centers for Medicare & Medicaid Services (CMS) will now require its surveyors to report suspected crimes to local law enforcement, such as patient abuse, theft, sexual assault or other unlawful activity. The agency inserted new language into Appendix Q of its State Operations Manual that in addition to the law enforcement requirement lays […]

TRICARE to Cover Concurrent Care for Pediatric Hospice Patients

TRICARE, the U.S. military’s health insurance program for uniformed service members and their families, will now pay for medical treatment concurrently with hospice care for pediatric patients with terminal illness. The rule change, made in accordance with the National Defense Authorization Act of 2018, applies to military dependents who are younger than 21. Before this […]

House Committee Seeks Answers from CMS on OIG Hospice Reports

Leaders in the influential Ways and Means Committee in the U.S. House of Representatives have called for stronger supervision of hospice regulatory programs in a letter to Seema Verma, administrator of the U.S. Centers for Medicare & Medicaid Services (CMS). Committee Chairman Richard Neal (D-Mass.) and Ranking Member Kevin Brady (R-Tex.) signed the letter requesting […]

CMS Final Rule Could Lead to More Hospice Audits

The U.S. Centers for Medicare & Medicaid Services (CMS) issued its annual final rule for hospice payments in Fiscal Year 2020, including a payment rebasing that raises rates 2.7% for three higher-acuity levels of care and cuts routine home care by a corresponding 2.7%. With regulatory scrutiny on the rise, some hospice providers are concerned […]

CMS Final Rule Rebases Payment Rates, Changes Election Statement

The U.S. Centers for Medicare & Medicaid Services (CMS) has rebased payment rates for the four levels of hospice care in a final rule for Fiscal Year 2020. Among other provisions the rule includes a new requirement that hospices provide an addendum to election statements that would detail care, treatment and services the patient would […]

New Senate Caucus to Focus on Palliative Care

A bipartisan group of U.S. Senators has launched a new caucus to focus on legislation and policy that impacts palliative care. The legislators said they expect the Comprehensive Care Caucus to raise awareness of palliative care, promote utilization, improve care coordination, support caregivers and expand access to palliative care services. Founding members of the Comprehensive […]

Confessions of a Hospice CEO: CMS Audits May Kill Us

Hospices are under increasing levels of regulatory scrutiny from the U.S. Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health & Human Services Inspector General’s Office (OIG), particularly in the form of audits, and many hospice leaders are expressing frustration with the associated costs and workload. Hospice News’ Confessions interviews give […]