Creative Hospice Care Inc. CEO Mahlega Abdsharafat has agreed to pay $9.2 million to settle allegations that the company and its affiliates were involved in fraudulent activities. The settlement was released by the U.S. Department of Justice (DOJ) on Wednesday resolved three lawsuits brought against the Georgia-based company and its affiliates, collectively dubbed the Creative […]
The U.S. Centers for Medicare & Medicaid Services’ (CMS) proposed 2.4% hospice base rate increase is woefully inadequate, and new physician attestation requirements may place undue burdens on providers, according to comments from the National Alliance for Care at Home. The Alliance on Tuesday released its public comments on the 2026 hospice payment rule, which […]
Hospice providers are facing an uphill battle when it comes to communicating quality as scammers step into the industry, leading to new misconceptions about their services. Fraudulent activity in the hospice space has exacerbated common misconceptions about end-of-life care, according to Beth Klint, executive director at Goodwin Hospice, which is part of Goodwin Living. Hospices […]
The U.S. Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz has issued a public announcement warning against the most common tactics being employed by fraudulent hospice operators. Program integrity concerns heating up in the hospice space in recent years have regulators increasingly seeking avenues to safeguard patients and their families against unscrupulous […]
The U.S. Centers for Medicare & Medicaid Services (CMS) should delay implementation of the Hospice Outcomes and Patient Evaluation (HOPE) tool, according to three national hospice and palliative care industry groups. LeadingAge, the National Alliance for Care at Home and the National Partnership for Healthcare and Hospice Innovation (NPHI) urged CMS to delay the transition […]
The U.S. House of Representatives recently passed a bill proposing an estimated more than $700 billion in Medicaid cuts during the next decade. The legislation’s potential impacts on community-based hospice care delivery could be significant, according to industry stakeholders. President Trump’s One Big Beautiful Bill Act includes a budget reconciliation process of tax reductions that […]
A bill currently before Congress seeks to overhaul aspects of the Medicare Advantage program. Rep. David Schweikert (R-Ariz.) recently introduced the Medicare Advantage Reform Act. If enacted, the bill, numbered H.R. 3467, would make wholesale changes to the Medicare Advantage (MA). A key provision of the bill is a proposed requirement that MA plans pay […]
The proposed California budget would require prior authorizations for hospice care within the state’s Medicaid program. Currently, Medicaid managed care plans who provide coverage through the state’s Medicaid system, Medi-Cal, may not perform prior authorizations for hospice. California’s Department of Health Care Services (DHCS) indicated in a 2025-2026 budget revision that this could save $25 […]
Rep. David Schweikert (R-Ariz.) has introduced the Medicare Advantage Reform Act, which among other provisions would require health plans to pay for hospice care. If enacted, the bill, numbered H.R. 3467, would make wholesale changes to the Medicare Advantage program. It would mandate capitated payment models, change risk adjustment methodologies and create new exemptions for […]
The insurance and health care company UnitedHealth Group (NYSE: UNH) may be under federal criminal investigation for alleged Medicare fraud. The U.S. Justice Department has not released the specific allegations against the company. However, they are reportedly related to UnitedHealth Group’s business practices within its Medicare Advantage plans, according to the Wall Street Journal, which […]
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