Hospices Ready Themselves for the Medicare Advantage Carve-In

Though hospices remain in the dark about the inner workings of the forthcoming Medicare Advantage carve-in, some are using their knowledge and experience in working with payers to take the first steps toward implementation. The U.S. Centers for Medicare & Medicaid Services (CMS) earlier this year announced that it would test coverage of hospice care […]

Wisconsin Legislature Mulls Palliative Care Bill

A bi-partisan bill before the Wisconsin Legislature would set up a Palliative Care Council within the state’s Department of Health Services, as well as establish a public education program on palliative care. If the bill is enacted, Wisconsin will join a growing list of states in establishing laws to promote palliative care as legislators and […]

OIG: CMS Needs to Stop Paying for Some Hospice-Related Drugs Twice

The Centers for Medicare & Medicaid Services (CMS) needs to do more to make sure taxpayer dollars aren’t being wasted when it comes to paying for hospice patients’ drugs, a report released Tuesday by the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) found. As part of an ongoing audit […]

CMS Proceeding on New Hospice Quality Measure Development

The U.S. Centers for Medicare & Medicaid Services (CMS) is developing two new claims-based quality measures for hospices, to track avoidable transitions from hospice care as well as access to levels of hospice care. CMS does not require hospices to collect or submit data on claims-based measures. The agency itself assembles the data based on […]

MA Carve-In Could Forego 6-Month Prognosis Rule for Hospice

Medicare Advantage plans would not necessarily be bound by Medicare’s six-month terminal prognosis requirement under a forthcoming hospice carve-in. Medicare Advantage plans are offered by private insurance companies approved by CMS, and include HMO, PPO, and fee-for-service plans among other options. The program represents an integrated care model that is designed to promote coordination of […]

New Jersey Enacts Law to Expand Palliative Care

New Jersey has joined a growing list of states that are establishing laws to advance palliative care. Gov. Phil Murphy (D) has signed a bill to create a state advisory council on palliative care and quality of life. The new law also includes provisions for a hospice and palliative care access program to expand public […]

CMS Revises Immediate Jeopardy Citation Process

The U.S. Centers for Medicare & Medicaid Services (CMS) will now require its surveyors to report suspected crimes to local law enforcement, such as patient abuse, theft, sexual assault or other unlawful activity. The agency inserted new language into Appendix Q of its State Operations Manual that in addition to the law enforcement requirement lays […]

TRICARE to Cover Concurrent Care for Pediatric Hospice Patients

TRICARE, the U.S. military’s health insurance program for uniformed service members and their families, will now pay for medical treatment concurrently with hospice care for pediatric patients with terminal illness. The rule change, made in accordance with the National Defense Authorization Act of 2018, applies to military dependents who are younger than 21. Before this […]

House Committee Seeks Answers from CMS on OIG Hospice Reports

Leaders in the influential Ways and Means Committee in the U.S. House of Representatives have called for stronger supervision of hospice regulatory programs in a letter to Seema Verma, administrator of the U.S. Centers for Medicare & Medicaid Services (CMS). Committee Chairman Richard Neal (D-Mass.) and Ranking Member Kevin Brady (R-Tex.) signed the letter requesting […]

CMS Final Rule Could Lead to More Hospice Audits

The U.S. Centers for Medicare & Medicaid Services (CMS) issued its annual final rule for hospice payments in Fiscal Year 2020, including a payment rebasing that raises rates 2.7% for three higher-acuity levels of care and cuts routine home care by a corresponding 2.7%. With regulatory scrutiny on the rise, some hospice providers are concerned […]