Hospices need a three-pronged approach to prepare for, respond to and appeal audits as more providers come under a wider regulatory microscope. A wide swath of auditing activity has ramped up in the hospice space as regulators seek to improve program integrity and quality oversight. More than half of hospice providers reported having multiple types […]
Lawmakers have put forth bills in both the Senate and the U.S. House of Representatives to foster greater utilization of advance care planning. The Compassionate Care Act would establish a nationwide public education campaign to educate the people in the United States about the importance of advance care planning, including grants and pilot initiatives to […]
Regulators are sharpening their focus on several aspects of hospice quality data to help weed out fraud, waste and abuse. Hospice Quality Reporting Program (HQRP) requirements have seen an overhaul in recent years as the U.S. Centers for Medicare & Medicaid Services (CMS) works to curb malfeasance in the industry. Program integrity concerns have been […]
The Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act, if enacted, would make changes to the ways hospices provide respite care. Rep. Earl Blumenauer (D-Oregon) is in the process of drafting the bill that would represent the most significant reforms to date for hospice payment and oversight. The legislation is currently in a discussion […]
The U.S. Centers for Medicare & Medicaid Services (CMS) on Tuesday finalized its 2025 hospice payment rule, but some say that the base rate increase is insufficient in today’s environment. CMS approved a 2.9% raise in per diem hospice payments, which is higher than the 2.6% the agency initially proposed. Stakeholders in the space contend […]
The U.S. Centers for Medicare & Medicaid Services (CMS) has unveiled its final 2025 hospice rule, which includes a 2.9% increase in per diem payments alongside new quality reporting measures. The increase represents an estimated $790 million rise in total hospice payments compared to Fiscal Year (FY) 2024. It is also higher than the 2.6% […]
A hospice physician in California is facing up to a decade in prison after pleading guilty for their involvement in a kickback fraud scheme that bilked Medicare of nearly $30 million. Two years following his arrest, Dr. Victor Contreras, 68, recently pled guilty to one count of health care fraud. Contreras served as a physician […]
The most recent iteration of Hospice Care Accountability, Reform and Enforcement (Hospice CARE) Act, currently in a discussion draft phase, could have some unintended consequences in the future of end-of-life care delivery. Developed by U.S. Rep. Earl Blumenaur (D-Oregon) and announced in June at the Hospice News Elevate conference, the bill proposed reimbursement and regulatory […]
The Medicare Hospice Benefit is ripe for change nearly four decades after its establishment, but moving the needle will include a heavy lift around evolving regulations. This is according to Bill Dombi, president of the National Association for Home Care & Hospice (NAHC). The hospice industry is undergoing tremendous changes amid rising demand and increased […]
Seven individuals in Arizona face federal charges for their alleged roles in defrauding Medicare out of hundreds of millions of dollars in total. The charges for the most part stem from submitting Medicare claims for patients who were not eligible for hospice care, as well as fraud related to behavioral health services. The arrests were […]
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