Among the numerous tactics that unscrupulous hospices use to commit fraud, three are rising to the forefront. Four states have garnered national attention as fraud hotbeds — Arizona, California, Nevada and Texas. These regions have seen swarms of new hospices emerging and receiving Medicare dollars. Numerous reports of unethical or illegal practices have surfaced, particularly […]
Hospices are preparing for an onslaught of potential operational impacts with the forthcoming implementation of the U.S. Centers for Medicare & Medicaid Services’ (CMS) new Hospice Outcomes and Patient Evaluation (HOPE) tool. The agency’s 2025 final rule announced that the HOPE tool will take effect in October 2025, and will replace the Hospice Item Set […]
The U.S. Department of Justice’s (DOJ) lawsuit against Amedisys Inc. (Nasdaq: AMED) and UnitedHealth Group (NYSE: UNH) will go to mediation on Aug. 18. The DOJ sued the two companies starting in November of last year to block the UnitedHealth Group subsidiary Optum from acquiring Amedisys due to antitrust concerns. The case will now go […]
The U.S. Centers for Medicare & Medicaid Services (CMS) on Friday announced its proposed 2026 hospice payment rule, which includes a 2.4% base rate increase alongside changes to quality reporting measures. The increase represents an estimated $695 million rise in total hospice payments for Fiscal Year (FY) 2026. It is also lower than the 2.9% […]
The U.S. Senate has confirmed Dr. Mehmet Oz as administrator of the U.S. Centers for Medicare & Medicaid Services (CMS), where he will oversee the nation’s largest health insurance programs — including the Medicare Hospice Benefit. The chamber voted to confirm on Thursday along party lines — 53 to 45. During a confirmation hearing in […]
Program integrity challenges in the organ procurement and transplant space have led to national legislative reform. Palliative care providers are seeking to help families understand and address these issues to ensure goal-concordant care delivery. Palliative care patients and their families navigate a host of legal, medical and logistical considerations when navigating complex organ donation and […]
The U.S. Department of Health & Human Services (HHS) on Thursday announced thousands of employee layoffs, resulting in a loss of nearly one-quarter of its full-time workforce. The layoffs are part of a restructuring process in accordance with an executive order from the Trump administration known as the Implementing the President’s “Department of Government Efficiency” […]
The State of Illinois legislature is advancing bills that would provide additional support for patients nearing the end of life. The Illinois General Assembly’s House of Representatives has advanced four bills related to hospice and palliative care that were recently cleared by a legislative committee. They pertain to issues like medication delivery, advance care planning […]
A federal court has ordered a stay on litigation intended to block the hospice Special Focus Program (SFP) after the U.S. Centers for Medicare & Medicaid Services (CMS) pledged that it would not resume implementation during 2025. The crux of a lawsuit filed by hospice organizations against the U.S. Department of Health and Human Services […]
Telehealth policies and program integrity concerns represent two of the leading regulatory issues on hospices’ radar this year. Regulatory changes and increasing oversight were the second-most cited concerns among nearly a quarter (21%) of 112 hospice professionals who participated in this year’s Outlook Survey by Hospice News and Homecare Homebase. Challenges around staffing and improved […]
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