A proposed rule from the U.S. Drug Enforcement Agency (DEA) may imperil hospice patients’ access to essential medications, stakeholders have indicated. The DEA recently proposed a regulation for prescribing controlled substances via telemedicine after the COVID-19 Public Health Emergency (PHE) expires. If finalized as written, practitioners would no longer have the ability to prescribe Schedule […]
The 2024 proposed hospice rule from the U.S. Centers for Medicare & Medicaid Services (CMS) signals the agency’s earliest response to widespread calls to bolster program integrity within the benefit. In additional to a 2.8% hike in the per diem base rate, the proposal includes new requirements around who can certify patients, health equity initiatives, […]
The U.S. Centers for Medicare & Medicaid Services (CMS) late Friday released the 2024 proposed payment rule for hospice providers. In it, CMS proposed to update hospice payments by 2.8%, which includes a market-basket percentage increase of 3% and a 0.2 percentage point productivity adjustment. The increase would translate to an estimated $720 million swell […]
Rep. Earl Blumenauer (D-Ore.) has introduced a bill that would allow some end-of-life patients to use psilocybin and other investigational treatments. The Right to Try Clarification Act would revise a current law that was designed to give access to experimental treatments to dying patients who have exhausted other options. The proposed bill would add Schedule […]
Though evidence shows that longer hospice stays reduce costs, providers are still walking a regulatory tightrope. On one hand, longer hospice stays can lead to improved patient and family satisfaction and greater cost saving opportunities. On the other hand, regulators often treat stays longer than six months or frequent recertifications to be red flags that […]
On the matter of hospice program integrity, policymakers have many questions and few answers. U.S. Health and Human Services Secretary Xavier Becerra appeared yesterday on Capitol Hill for a hearing on President Biden’s proposed federal budget, during which several Congress members raised the issue of hospice fraud. The key issue in these discussions is a […]
Current advance care planning reimbursement structures are limiting utilization and access of these services, particularly among communities of color. The payment barriers blocking more equitable advance care planning are two-fold, existing on both the health care provider and patient sides. On the patient side, Medicare beneficiaries face out-of-pocket costs when advance care planning is performed […]
Despite years of scrutiny over the duration of hospice care, new data show that longer stays reduce health care costs in the last year of life by as much as 11%. All told, hospice care — regardless of length of stay — saves Medicare approximately $3.5 billion for patients in their last year of life, […]
Utah-based Summit Hospice has agreed to settle allegations of False Claims Act violations for $1.05 million. The U.S. Department of Justice indicated that claims resolved by the settlement are allegations only and liability was not determined. The U.S. Attorney’s Office for the District of Utah investigated the allegations, along with the state’s Medicaid Fraud Control […]
Hospice program integrity has been in the spotlight for at least the past two years, often with high financial stakes for providers. Unified Program Integrity Contractor (UPIC) and Targeted Probe and Educate (TPE) audits are designed to key regulatory safeguards against bad actors in the hospice industry. Both include oversight measures aimed at ensuring hospice […]
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