The U.S. Centers for Medicare & Medicaid Services (CMS) recently funneled $10 billion into a federal program designed to improve rural health disparities. The new funding comes in the second year of CMS’ Rural Health Transformation Program (RHTP), which is designed to make healthcare more accessible in rural and remote regions. The agency unveiled […]
The U.S. Centers for Medicare & Medicaid Services (CMS) has finalized its 2027 home health rule, which contains significant regulatory updates that affect all healthcare providers. In addition to those provisions, the agency implemented an aggregate payment increase of 2.4%, or approximately $420 million, a departure from recent years in which home health providers have […]
The U.S. Centers for Medicare & Medicaid Service (CMS) is locking horns with scammers, and hospices need a transparent view into the agency’s methods. CMS routinely monitors billing activity, beneficiary complaints and other indicators that may signal potential fraud, an agency spokesperson told Hospice News. When suspicious activity is identified, the agency can take several […]
Congress and federal agencies have been examining the prospect of adjusting – or overhauling – hospice reimbursement systems. This is based on introduced pieces of legislation and a series of government reports from agencies like the Government Accountability Office (GAO), the U.S. Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health […]
The U.S. Centers for Medicare & Medicaid Services’ (CMS) temporary moratoria on hospice and home health provider enrollment in Medicare has been working, according to Kimberly Brandt, the agency’s deputy administrator and COO. To date, during the six-month enrollment freeze, CMS has denied 50 hospice and 250 home health applications. Also, CMS has seen “huge […]
Six medical professionals were recently arrested for their alleged involvement in a $138 million scheme that spanned three separate hospices. The suspects are accused of submitting false Medicare billing claims for patients who were not eligible to receive hospice care. The scheme is part of a larger case in California recently announced by the U.S. […]
Hospices need adaptive policies that address the various uses of artificial intelligence (AI) across their clinical and organizational operations. Providers lacking governance around these evolving technologies may face significant operational and compliance risks, according to legal experts. Hospices are navigating a complex compliance landscape as AI tools increasingly come into the mix of care delivery, said Tayor […]
Some Medicaid managed care plans are continuing to fail to make pass-through room-and-board payments to hospices for patients in California nursing homes. The issue pertains to nursing home residents who are dually eligible for Medicare and Medicaid. Hospices typically cover these patients’ room-and-board costs with the expectation that Medicaid will reimburse them for the expenses. […]
Homestead Hospice has reached a $1.93 million settlement agreement for the company’s alleged involvement in False Claims Act violations. U.S. District Judge Thomas Thrash Jr. recently released the settlement agreement in a lawsuit brought under qui tam provisions more than a decade ago. These “whistleblower” cases involve alleged violations of the anti-kickback statute and the […]
Federal and regulatory agencies are using artificial intelligence (AI) tools to address program integrity issues in the hospice space. Some legitimate providers may not sustain the potential unintended consequences of data-driven oversight, according to legal experts. In the final installment of a two-part series, Hospice News explores how AI-fraud tactics could impact legitimate hospices’ sustainability […]
