HHS Issues Two Interoperability, Data Sharing Rules Applicable to Hospice

Two final rules released by the U.S. Department of Health and Human Services (HHS) are designed to improve information technology interoperability among health care providers, including hospices, as well as provide patients with greater access to their own health data. The two regulations will be administered by the Office of the National Coordinator for Health […]

Aseracare Settles False Claims Act Suit for $1 million

Hospice provider AseraCare has agreed to a $1 million settlement with the U.S. Department of Justice in a longstanding Qui Tam False Claims Act (FCA) case that began in 2008. The outcome of the case could set an important precedent as FCA suits continue to be the most prevalent enforcement actions that target hospices in […]

CMS Releases Capitation Rates for Hospice Coverage Through Medicare Advantage

The U.S. Centers for Medicare and Medicaid Services (CMS) has announced the capitation rates for hospice care under the value-based insurance design model (VBID), often referred to as the Medicare Advantage hospice carve-in. The agency indicated that medicare advantage organizations (MAOs) during the first month of a patient’s stay would receive Medicare A/B capitated payments, […]

Primary Care First Direct Contracting: Where Hospice Fits

The first application deadline for participation in the Primary Care First direct contracting payment models expired Feb. 25, but even this late in the game, many in the hospice space and other health care stakeholders struggle to understand these models. The direct contracting options include three voluntary payment models that are designed to help the […]

New York state Updates Hospice Patient Medication Rule

New York state has clarified its policies for the self-administration of medications by hospice patients who live in adult care facilities. The new guidance addresses times those patients are no longer capable of taking medications themselves. According to a “Dear Administrator” letter from the New York state Department of Health, adult care facility (ACF) residents […]

Hospices Strategize to Stave Off Cap Overage Payments

Careful management of resources can help hospices avoid the need to repay Medicare for revenues that exceed the payment cap. Hospices that receive Medicare payments are likely familiar with payment caps: upper limits to the amount of funds a hospice can collect from Medicare in a single fiscal year. Hospices that exceed either the inpatient […]

Regulators Work to Strengthen Hospice Oversight

Congress is moving to give the U.S. Centers for Medicare & Medicaid Services (CMS) more authority to crack down on quality problems six months after the U.S. Department of Health and Human Services Office of the Inspector General (OIG) criticized the agency in two reports for not more closely enforcing hospice regulations. Meanwhile, CMS is […]

HOSPICE Act Would Increase Survey Frequency, Redesign Surveyor Training

Recently introduced legislation in the U.S. House of Representatives calls for increasing the frequency of hospice compliance surveys to every two years as opposed to the current policy of every three years. Among other provisions, the bill would also take steps to improve surveyor education and training. Reps. Jimmy Panetta (D-Calif.) and Tom Reed (R-N.Y.) […]

Ohio Allows Hospices to Provide Inpatient Palliative Care

New rules in the state of Ohio will allow hospices to admit non-hospice palliative care patients into their inpatient facilities on a short-term basis when medically necessary. About half of the community-based palliative care providers in the United States are hospices, according to recent research from the Center to Advance Palliative Care (CAPC). CAPC developed […]

Congress to Tackle Hospice Quality in New Legislation

Reps. Jimmy Panetta (D-Calif.) and Tom Reed (R-N.Y.) have introduced bipartisan legislation designed to strengthen regulatory oversight of hospice providers in the wake of two July 2019 reports from the U.S. Department of Health and Human Services Office of Inspector General (OIG). The reports garnered widespread media attention and elicited strong reactions from hospice organizations. […]