The U.S. Centers for Medicare & Medicaid Services (CMS) has issued its 2025 proposed rule for hospice payment, which if finalized would include a 2.6% increase in the per diem base rate. The proposal is a likely signal that CMS will not adopt a recent recommendation by the Medicare Payment Advisory Commission (MedPAC) to freeze […]
A federal court has dropped a False Claims Act (FCA) case against hospice provider Care Alternatives that has been working its way through the legal system for 16 years. The U.S. Department of Justice (DOJ) and four whistleblowers in 2008 filed the qui tam lawsuit against Care Alternatives Inc., doing business as Ascend Health. In […]
Regulators are taking a closer look at how hospices pay their marketing and outreach workforces to curb fraudulent activity tied to referral streams. Federal and state regulatory agencies have systems in place to detect fraud, waste and abuse in hospice, and some are honing on oversight of sales, marketing and outreach staff payment arrangements, according […]
Members of Congress are raising questions about the continued Medicare certification for new hospices in areas rife with fraud. U.S. Health and Human Services (HHS) Secretary Xavier Becerra fielded questions in a House Ways & Means committee hearing on Capitol Hill on Wednesday. Rep. Michelle Steel (R-Calif.) and Rep. Beth Van Duyne (R-Texas) fired questions […]
The U.S. Department of Justice (DOJ) is reportedly mulling a possible lawsuit to block the acquisition of Amedisys (NASDAQ: AMED) by the UnitedHealth Group (NYSE: UNH) subsidiary Optum. Amedisys stock dipped 0.6% following reports of a lawsuit under consideration, SeekingAlpha reported. Optum, a subsidiary of UnitedHealth Group (NYSE: UHN), in June 2023 penned its agreement […]
Telehealth flexibilities must become permanent U.S. Health and Human Services (HHS) Secretary Xavier Becerra indicated in a congressional hearing today. At the end of this year, telehealth flexibilities implemented during the pandemic are slated to expire. In a hearing before the U.S. House Ways and Means Committee Becerra said that HHS was willing to make […]
Wisconsin is among the states that have recently taken steps to improve palliative care access and awareness. Wisconsin legislators recently introduced a bill that would establish a statewide Palliative Care Council. If passed, the bill would require the state’s Department of Health Services (DHS) to create a group of palliative clinical professionals, patients and family […]
Connecticut legislators recently introduced a bill that aims to create a statewide pediatric hospice and palliative program. If enacted, the bill would require the Connecticut Department of Public Health (DPH) to create a plan for the development of the program and establish general statutes around its implementation. The plan would have to be completed by […]
Hospices, in aggregate, are showing improvement on the quality measure for visits in the last days of life. The number of registered nurse and social worker visits during a patient’s final week is one of the seven quality measures that CMS uses to evaluate providers. In Calendar Year 2021, the share of hospice care days […]
As hospice program integrity remains in the spotlight, California remains the only state to take action on curbing the problem. Beginning in 2021, numerous reports emerged of unethical or illegal practices among hundreds of newly licensed hospices, particularly among new companies popping up in California, Texas, Nevada and Arizona. California’s Department of Justice (CDOJ) in […]
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