Hospices Need to Understand Risk Within Medicare Advantage

As hospices wade into the complexities of value-based reimbursement models in 2021, they must learn to understand the relationship between payment and risk within programs like Medicare Advantage. Starting in 2021, providers will have the option to participate in a demonstration project testing the inclusion of hospice in the value-based insurance design model, commonly called […]

MJHS Hospice Settles Whistleblower Action for $5.225 Million

MJHS Hospice and Palliative Care in New York settled a whistleblower case against a former employee under the civil False Claims Act for $5.225 million. The hospice acknowledged resolution of the private citizen action filing in a statement shared with Hospice News. “The allegation was that medical record documentation for hospice levels of care for […]

Direct Contracting Payment Models to Allow Concurrent Hospice Care

The direct contracting component of the Primary Cares Initiative will allow eligible hospice patients to receive curative treatment while also receiving hospice care.  The direct contracting options include three voluntary payment models that are designed to help the U.S. Centers for Medicare & Medicaid Services (CMS) and health care providers reduce the cost of care […]

OIG Wage Index Recommendation Could Affect Hospice Payments

The U.S. Centers for Medicare & Medicaid Services (CMS) should revamp its use of the hospital wage index to determine payments for health care providers, according to a new report by the U.S. Department of Health and Human Services Office of the Inspector General. The agency uses the index among other information to calculate hospice […]

CMS Geographic Designations Could Slash Payment for Some Hospice Providers

The final rule governing hospice payment from the U.S. Centers for Medicare & Medicaid Services adopted a new method for defining different regions as rural or urban. This move could impact geographic adjustments to per diem amounts leading to payment reductions for some providers.  Effective at the start of the Fiscal Year in October, CMS […]

Hospices Struggle with Respite Care During Pandemic

The COVID-19 pandemic has complicated hospices’ ability to provide respite care. Limited access to nursing homes, fears of spreading the virus and rising demand are throwing wrenches into providers’ respite programs. Congress is currently considering legislation that during any federally declared national emergency would increase the maximum length of stay for hospice respite care to […]

Senate Bill Would Boost Hospice Respite Care During COVID-19

U.S. Sens. Sherrod Brown (D-Ohio) and Shelley Moore Capito (R-W.Va.) have introduced new legislation that would allow hospice patients to receive respite care in their homes during a national emergency, such as the ongoing COVID-19 pandemic. The bill would also extend the allowable length of stay to 15 days, up from the current limit of […]

CMS to Make Permanent COVID-19 Telehealth Rules, Hospice Role Uncertain

The U.S. Centers for Medicare & Medicaid Services (CMS) will be making permanent a number of the temporary flexibilities to expand telehealth that the agency implemented in response to the COVID-19 pandemic. The number of rules affecting hospices that would be extended remains to be seen. President Donald Trump signed an executive order that among […]

CMS Issues Hospices a 2.4% Pay Raise for 2021

Hospice payment rates will go up 2.4% during Fiscal Year 2021 according to a final rule issued by the U.S. Centers for Medicare & Medicaid Services (CMS). This falls slightly short of the 2.6% increase that the agency had proposed in April.  The change would increase annual Medicare hospice spending by $540 million, though providers […]

More COVID-19 Relief Funds Likely Coming to Hospices

The proposed HEALS Act currently before Congress would allocate an additional $25 billion to the Provider Relief Fund, a program that moves federal dollars to health care organizations struggling with the fallout of the pandemic, including hospices. The full price tag for the legislation could reach more than $1 trillion, though congressional negotiations are ongoing. […]