Two hospice operators in California have pleaded guilty on fraud and money laundering charges.The pair submitted false Medicare claims totalling close to $16 million. The scheme involved several conspirators, all of whom have been convicted or have pleaded guilty. Petros Fichidzhyan, Juan Carlos Esparza and Karpis Srapyan allegedly operated four sham hospice companies, which were […]
The Republican-driven “One Big Beautiful Bill,” recently signed into law, could trigger a higher percentage of hospice payment sequestration, as well as additional burdens on providers. The U.S. Centers for Medicare & Medicaid Services (CMS) currently sequesters hospice payments by 2%. However, the new law could result in a 4% increase. The key issue is […]
Hospices are subject to a rising number of investigations and audits from Medicare contractors, the U.S. Department of Health and Human Services Office of the Inspector General and, in some cases, the U.S. Justice Department, among others. Hospices need to understand the various types of investigations they may encounter and how to respond to them. […]
Preserving telehealth flexibilities, Medicare Advantage issues and the federal government’s looming hospice Special Focus Program were top of mind for hospice leaders from Texas during a recent visit to Capitol Hill. About 13 member organizations of the Texas Association for Home Care & Hospice (TAHC&H) recently attended more than 26 meetings with congressional lawmakers in […]
The U.S. House of Representatives has sent the Republican-led “One Big Beautiful Bill” to the White House for signature. The bill contains Medicaid cuts totaling $1 trillion over the next 10 years. This amounts to 15% of total federal Medicaid spending during that time period, according to the Kaiser Family Foundation. The reductions vary by […]
Three women associated with Houston-based United Hospice & Palliative Care (UPHC) have been charged with Medicaid and Medicare fraud after allegedly bilking more than $87 million in federal health care funds. The trio includes UPHC owner Dera Ogudo, an UPHC employee Victoria Martinez and a psychiatric hospital employee, Evelyn Shaw, ABC-13 Houston reported. The prosecutor’s […]
Regulatory challenges have been brewing for the past five years following the U.S. Centers for Medicare & Medicaid Services’ (CMS) move to revamp requirements to the hospice election statement. CMS’ final rule for Fiscal Year 2020 included a new requirement that hospices, upon request, provide an addendum to election statements detailing the care, treatment and […]
The U.S. Centers for Medicare & Medicaid Services has called for a 6.4% aggregate cut to home health payments for 2026 in a proposed rule released on Monday. The total reductions amount to $1.135 billion. The proposed payment changes break down into a 224% increase in home health payments. This is offset by a 3.7% […]
The U.S. Centers for Medicare & Medicaid Services (CMS) is exploring prior authorizations within traditional Medicare for some services. The Center for Medicare & Medicaid Innovation is launching a demonstration program called the Wasteful and Inappropriate Service Reduction Model, aimed at applying advanced technology to prior authorization processes within traditional Medicare. “WISeR will harness enhanced […]
Mihran Panosyan of Winnetka, California, has pleaded guilty for his alleged involvement in a money laundering scheme that bilked Medicare of nearly $16 million. Panosyan entered a guilty plea on Monday to charges of Medicare billing fraud and laundering more than $4.6 million through sham hospice companies, according to an announcement from the U.S. Department […]
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