CMS, CDC Update Nursing Home Visit Guidelines for Hospices, Other Visitors

The U.S. Centers for Medicare & Medicaid Services (CMS) and the U.S. Centers for Disease Control and Prevention (CDC), have revised their previous guidance for visitors accessing nursing homes, including service providers such as hospices. The availability of vaccines was a key factor in the update.  The agencies now indicate that facilities can allow ”responsible […]

COVID-19 Stimulus Passes with Support for Rural Hospices, but No Additional PRF

The American Rescue Plan of 2021 has cleared its last congressional hurdle before going to President Biden for signature. The $1.9 trillion stimulus package contains $8.5 billion in aid targeted at rural providers, including hospices. However, the bill did not increase the Provider Relief Fund (PRF) or extend the moratorium on payment sequestration.  The U.S […]

Hospices Adjust to New CMS Addendum Rule

Hospices have shifted staff training as well as patient admission and documentation processes amid a barrage of changes since the U.S. Centers for Medicare & Medicaid Services (CMS) issued the election statement addendum rule Oct. 2020. While the new rule could stand to improve patient awareness and understanding of hospice, providers who fail to comply […]

CMS Delays Primary Care First SIP Payment Model Indefinitely

The U.S. Centers for Medicare & Medicaid Services (CMS) is delaying implementation of the Primary Care First Serious Illness Population payment model and has not announced a new start date. The agency indicated the delay in a note on its Primary Care First website, promising more information in the near future. The model had previously […]

Hospices Struggle to Unwrap PRF Funding Requirements

Provider Relief Funds issued by the federal government during COVID-19 have done much to alleviate some of the financial strain placed on hospice providers. To fully realize the benefits, organizations must ensure they understand the eligibility requirements and procedures for reporting lost revenue. With a deadline approaching and confusion proliferating about allowable expenses, hospices are […]

Husch Blackwell Secures $44 Million Cut in Hospice Overpayments

Health care law firm Husch Blackwell secured a $44 million reduction in Medicare overpayment charges for an unnamed hospice client involved in an audit. The firm’s hospice and palliative care team appealed the overpayment finding, and the U.S. Centers for Medicare & Medicaid Services (CMS) dismissed the claim denials. This left the hospice with a […]

Hospice Advocates: Extend Sequestration Moratorium

A number of health care industry organizations — including the National Hospice & Palliative Care Organization (NHPCO) and the National Association for Home Care & Hospice (NAHC) — have written to congressional leaders requesting an extension of the temporary suspension of reimbursement sequestration. The U.S. Centers for Medicare & Medicaid Services (CMS) suspended sequestration for […]

Hospice, Senior Care Organizations Alert Biden to Policy Priorities

Access to vaccines and additional provider relief are top policy priorities for hospice and palliative care organizations as the Biden Administration takes shape. As Congress and the White House mull over a new $1.9 trillion COVID-19 stimulus package, serious illness care providers and industry groups are advocating for sorely needed assistance. The House recently approved […]

U.S. Supreme Court Declines to Hear Hospice False Claims Case

The U.S. Supreme Court has declined to hear arguments in a False Claims Act (FCA) case involving the hospice provider Care Alternatives. FCA actions pertaining to hospices most commonly focus on questions of a patient’s eligibility for those services. A report from Bass, Barry, and Sims shows that a leading cause of fraud involves hospices […]

Mhiramarc Exec Sentenced in $28 Million Hospice Fraud Scheme

Antonio Olivera, administrator of Southern California-based home health and hospice agency Mhiramarc Management LLC, was sentenced to 30 months in prison for his role in a Medicare fraud scheme involving $28 million in falsified health care claims.  Olivera pled guilty to one count of conspiracy to commit health care fraud in November 2020, resulting in […]