Biden to Nominate Chiquita Brooks-LaSure to Lead CMS

President Joe Biden will nominate Chiquita Brooks-LaSure for administrator of the U.S. Centers for Medicare & Medicaid Services (CMS), the Washington Post has reported. Thus far, neither CMS or the White House has made a public statement on the nomination. The nomination is subject to Senate approval. If confirmed, Brooks-LaSure will lead the agency at […]

HHS Releases New PRF Funding Requirements, Delays First Reporting Deadline

The U.S. Department of Health & Human Services (HHS) released new reporting requirements and guidance for the billions of dollars distributed to health care providers battling the pandemic. Hospice providers and advocates are calling for clarification around allowable expenses as the first reporting deadline looms in the horizon. Wading through these murky waters will take […]

Regulators Have Eyes Fixed on Hospice Fraud Cases

Hospice organizations and private equity investors are under increasing legal and regulatory scrutiny related to medical necessity complaints under the False Claims Act. A report from Bass, Barry, and Sims shows that a leading cause of fraud involves hospices billing Medicare for services for which patients were not eligible. This resulted in several multi-million dollar […]

Merida CEO Sentenced to 15 Years for Hospice Fraud

CEO Henry McInnis of Merida Health Group in Texas has been sentenced to 15 years in prison for his role in a $154 million Medicare fraud scheme involving false claims for hospice care. A jury in 2020 found McInnis, company owner Rodney Mesquias, and medical director Francisco Pena guilty of conspiracy to commit health care […]

Allstate Hospice Founders Settle Fraud Case for $1.8 Million

The founders of Texas-based Allstate Hospice and Verge Home Health Care have paid more nearly $1.85 million following a fraud investigation pertaining to the Stark Law. Onder Ari and Sedat Necipoglu have been accused of engaging in improper payments to physicians for hospice referrals. The Physician Self‑Referral Law, commonly known as the Stark Law, forbids […]

NHPCO Voices Hospice Priorities to Biden Administration

As Joe Biden prepares to launch his administration, hospice industry stakeholders are calling for stepped up vaccinations for staff, aid for additional personal protective equipment (PPE) and extension of regulatory flexibilities implemented during the COVID-19 pandemic.   The National Hospice & Palliative Care Organization (NHPCO) has written to Biden to push for hospice priorities as the […]

MEDPAC Votes to Slash Hospice Aggregate Payment Cap

The Medicare Payment Advisory Commission (MEDPAC) has voted unanimously to eliminate the update to the Fiscal Year 2021 Medicare base payment rates for hospice for Fiscal Year 2022 and to cut by 20% the hospice aggregate cap. The payment cap is the upper limit to the amount of funds a hospice can collect from Medicare […]

NAHC Analysis Shows Progress from Federal COVID Relief, but More Likely Needed

Programs established in the most recent COVID-19 relief legislation, passed in December, will go a long way to bolstering hospices that have taken operational and financial punches from the pandemic. A recent analysis from the National Association for Home Care & Hospice indicates that providers will likely need more support to ride out the continuing […]

Congress Members Call for Medicare Palliative Benefit

Members of the congressional physician’s caucus have written to U.S. Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma to advocate for a Medicare palliative care benefit demonstration. Reps. Neal Dunn, M.D (R-Fla), Phil Roe, M.D. (R-Tenn.), Jeff VanDrew (D-N.J.), and Sen.-Elect Roger Marshall (R-Kan.) signed the letter.  CMS tests the viability and functionality […]

Omnibus Federal Spending Bill Contains Major Hospice Provisions

After much debate, the U.S. Congress approved Consolidated Appropriations Act of 2021, which will keep the government running and fund federal agencies into the new year. The bill, which the president is expected to sign, includes hospice-specific line items intended to improve rural access to services and retool regulatory enforcement, as well as provide COVID-19 […]