Taking employee concerns seriously about patient eligibility and other issues can help prevent hospices from becoming involved in a False Claims Act case. The overwhelming majority of False Claims Act cases involve qui tam whistleblowers, usually a current or former employee who observed alleged malfeasance or errors. In a qui tam action, a whistleblower, called […]
The U.S. Centers for Medicare & Medicaid Services (CMS) has not responded to congressional concerns about the hospice Special Focus Program (SFP). Set for 2025 implementation, the SFP promises to identify hospices delivering poor quality care and target them for improvement remedies. However, many stakeholders, including members of Congress and hospice industry groups, have contended […]
Gentiva has filed a lawsuit against Bristol Hospice alleging that a former employee violated agreements with the company, including those for noncompetition and confidentiality. The company filed the suit in a federal court in Maine. Gentiva alleges that a registered nurse administrator disclosed trade secrets after leaving the company and securing employment with Bristol. The […]
Nautic Partners and The Vistria Group, the private equity backers of home health and hospice provider Vital Caring, are mulling a potential appeal of a federal court’s recent decision in a dispute with Encompass Health (NYSE: EHC) and Enhabit Inc. (NYSE: EHAB). A federal judge in Delaware on Monday ordered VitalCaring, Nautic and Vistria to […]
Regulators recently extended certain temporary telemedicine waivers granted during the pandemic, with some flexibilities now sunsetting in 2025 rather than the end of this year. The U.S. Drug Enforcement Administration (DEA) and the U.S. Department of Health and Human Services (HHS) have announced the extension of telemedicine flexibilities for the prescribing of controlled medications until […]
A federal judge in Delaware has ordered home health and hospice provider VitalCaring and its private equity backers to share future profits with Encompass Health (NYSE: EHC) and Enhabit Inc. (NYSE: EHAB). The case has a long circuitous history that dates back to 2022 when Encompass Health spinned off its home health and hospice business […]
The past year has seen a slew of regulatory developments aimed at improving quality and combatting fraud in the hospice industry. The drive by regulators and members of Congress to strengthen oversight is fueled by two main factors. The first was two July 2019 reports on hospice quality from the Office of the Inspector General […]
The Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, currently winding its way through Congress, would likely increase access to hospice and palliative care for veterans, if enacted. The omnibus veterans’ benefits reform bill contains two provisions in particular that could influence hospice and palliative care utilization. First, it contains language from […]
A number of hospices did not comply with requirements of the Provider Relief Fund (PRF) program during the COVID-19 pandemic. The $178 billion PRF was established in 2020 to help health care providers replace revenue lost due to altered utilization patterns and higher costs. The U.S. Health Resources and Services Administration (HRSA) administered the program. […]
The soon-to-be-implemented hospice Special Focus Program (SFP) from the U.S. Centers for Medicare & Medicaid Services (CMS) may produce misinformation that could interfere with access to care. The program, set to begin Jan. 1, 2025, could potentially lead patients away from quality providers and into the arms of bad actors in the space, according to […]
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