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 […]
Many hospice providers are struggling to grow amid the U.S. Centers for Medicare & Medicaid Services’ (CMS) temporary moratoria on hospice and home health enrollment in Medicare. Now, they must prepare for what may come next, according to industry experts. The six-month hospice and home health moratoria are set to expire Nov. 13. The national […]
Hospices must provide all patients with an addendum to the election statement when they enroll in services to comply with a new requirement that took effect on Thursday. The U.S. Centers for Medicare & Medicaid Services (CMS) mandated the requirement in the final hospice payment rule for FY 2027. The addendum outlines what is and […]
Though the U.S. Centers for Medicare and Medicaid Services (CMS) has regulatory authority over hospices, Congress has a role to play. To fulfill that role, they should listen to the concerns of hospice providers, according to Rep. Jimmy Panetta (D-Calif.). Panetta first took office in 2017 and currently serves on the Ways and Means Committee, […]
Some legal and technology experts have grown increasingly concerned by a potential lack of human oversight in artificial intelligence-assisted hospice regulatory enforcement. The AI-driven efforts to crackdown on fraudulent activity could bring significant impacts for legitimate providers, including risk of revocation and closure. In the first of a two-part series, Hospice News sits down with […]
U.S. Sens. Tammy Baldwin (D-Wis.) and Shelley Moore Capito (R-W.Va.) remain committed to passing the Palliative Care and Hospice Education Training Act (PCHETA). If enacted, PCHETA would provide support for hospice and palliative care training programs for physicians, nurses, pharmacists, social workers and chaplains. The legislation would also expand continuing education and career-development opportunities, as […]
The U.S. Centers for Medicare & Medicaid Services (CMS) has begun the process of revising the hospice Conditions of Participation (CoPs) for the first time in 20 years. The agency’s Center for Clinical Standards & Quality (CCSQ), Clinical Standards Group (CGS), announced the project in late September. On Thursday, LeadingAge, an advocacy group of nonprofit […]
Hospices’ compliance and legal risks could be rising alongside their increased use of artificial intelligence (AI) technologies, according to law experts. More providers are leaning into AI-enabled tools to improve quality, compliance and clinical documentation, according to Bryan Nowicki, partner at the law firm Husch Blackwell. Hospice organizations that are not currently considering or using […]
