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 […]
Hospice licensing should remain under the authority of state governments rather than federal agencies, though lawmakers “haven’t ruled anything out” when it comes to program integrity, according to Rep. Beth Van Duyne (R-Texas). The congresswoman and fellow legislator Rep. Earl Blumenauer (D-Ore.) last month requested a briefing from the U.S. Centers for Medicare & Medicaid […]
Hospices are seeking greater clarity on updated Medicare rules that allow hospices to document a broader range of chaplain services on claims. The U.S. Centers for Medicare & Medicaid Services’ (CMS) recently revised three existing items in the Healthcare Common Procedure Coding System (HCPCS), eliminating languages that limited their use to the health care arm […]
Axxess founder and CEO John Olajide discovered a passion for both business and technology at an early age, and in time, saw opportunities to leverage those interests to help modernize health care. Born in Lagos, Nigeria, Olajide’s first job involved handling money for his family’s wholesale and retail distribution business. Consequently, matters of management and […]
Members of Congress are seeking answers from federal regulators on hospice program integrity as industry advocacy groups call for further action. Reps. Beth Van Duyne (R-Texas) and Earl Blumenauer (D-Ore.) led a group of lawmakers who wrote to Chiquita Brooks-LaSure, administrator of the U.S Centers for Medicare & Medicaid Services (CMS), asking for the agency […]
The Medicare Hospice Benefit should allow some concurrent care, and Congress should support greater access to palliative care, among other reforms, according to LeadingAge. The senior care advocacy organization wrote to Congressional leaders today calling on lawmakers to devote attention to improving the 40-year-old benefit. In addition to concurrent care, LeadingAge urged Congress and the […]
U. S. District Judge Debra Brown has sentenced a Mississippi hospice physician to five years in prison for taking $16 million in fraudulent Medicare claims. Dr. Scott Nelson of Clevland, Mississippi was convicted last April of certifying patients for hospice who were not terminally ill. Some of these patients were able to testify in court […]
Regulators are keeping a closer watch for possible kickback schemes among hospices. Along with False Claims Act cases, anti-kickback violations are among the most commonly occuring forms of hospice fraud and abuse. Hospices need to have a careful eye on compliance when it comes to structuring referral arrangements to ensure they in compliance with the […]
The U.S. Centers for Medicare & Medicaid Services (CMS) has offered further guidance on what rules will change when the COVID-19 public health emergency (PHE) ends on May 11. Generally, the temporary flexibilities and waivers will expire with the federal declaration. Still, some will continue in a modified form or end within different time frames […]
As California pursues hospice licensing reform, some providers in other states are watching for similar actions closer to home. In December, California Gov. Gavin Newsom (D) approved legislation that tightened hospice oversight in the state. This includes establishing a moratorium on new hospice provider licenses until the California Department of Public Health (CDPH) sets emergency […]
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