Bill Would Streamline Medicare Advantage Prior Authorizations

As hospices ready themselves for a Medicare Advantage (MA) carve-in, U.S. Reps. Suzan DelBene (D-Wa.) and Mike Kelly (R-Pa.) plan to introduce a bill to reduce regulatory burdens associated with the prior authorization process, a legislative aide from DelBene’s office told Hospice News. Though the bill text is not yet complete, the co-sponsors are basing […]

CMS to Fix Claims Issues, Revises Appeal Rules

The U.S. Centers for Medicare & Medicaid Services (CMS) is working to fix bugs in the Medicare claims processing system resulted in underpayments to hospices during 2018 and early 2019. The agency also alerted hospices to revised rules for electronic signatures and appeals. CMS last year altered Medicare’s claims processing systems to better identify prior […]

WSJ Editorial Debates Hospice Fraud Case

A major fraud case centered around live hospice discharges is being argued not only in 11th Circuit Court of Appeals, but in the editorial pages of the Wall Street Journal. Kyle Clark and Andrew George, trial lawyers for the Washington-based law firm of Baker Botts published a recent editorial, “Medicare’s Hospice Rules Could Make Your […]

Rural Access to Hospice Bill Expected to Pass

First proposed in 2017, the Rural Access to Hospice Act is expected to pass the 116th Congress due to widespread bipartisan support, according to hospice policy advocates. U.S. Senators Shelley Moore Capito (R-W.Va.) and Jeanne Shaheen (D-N.H.), reintroduced the legislation last week. If enacted it would remove a statutory barrier in current law, allowing patients […]

CMS Will Not ‘Unbundle’ Hospice Care Under Medicare Advantage

The U.S. Centers for Medicare & Medicaid Services (CMS) has affirmed that beneficiaries receiving hospice care covered under a Medicare Advantage carve-in would not lose access to services they currently receive as part of the hospice benefit. This affirmation addresses a question that has lived in the minds of hospice providers since the agency announced […]

CMS to Delay Hospice Compare Data on ‘Imminent Death’ Quality Measure

Citing a need for further testing, the U.S. Centers for Medicare & Medicaid Services (CMS) will not release Hospice Compare data on hospice visits during the last seven days of life as expected this summer. CMS uses Hospice Compare to publicly report hospice provider performance on quality measures.Referring organizations such as hospitals and nursing homes, […]

Congress Tackles Hospice and Palliative Care Staffing Shortage

More patients than ever are seeking hospice and palliative care, and the industry may not have enough trained clinicians to take care of them. To help fill this gap, Rep. Eliot L. Engel (D-NY) and 285 bipartisan co-sponsors have reintroduced the Palliative Care and Hospice Education and Training Act (H.R. 647) in the House of […]

Improper CMS Payments to Hospices Top $2.1 Billion in 2018

Medicare made an estimated $2.1 billion in improper fee-for-service payments to hospices during fiscal year 2018, with more than half occurring due to documentation errors, the Government Accountability Office (GAO) reported. The GAO investigation focused solely on fee-for-service payments and did not examine Medicare’s managed care or outpatient prescription drug programs. Though the overall report […]

West Virginia Law Limits New Hospice Providers

Gov. Jim Justice has signed legislation that could impact the future of hospice care in West Virginia. State Senate Bill 537 establishes a workgroup to review certificate of need regulations that could prevent new hospice providers from opening in the state. A major consideration is the question of thresholds for permitting additional hospice providers in […]

Ohio Law: Inform Patients About Palliative Care

Under a new Ohio law , hospitals, ambulatory surgery centers, nursing homes, and other health care organizations in Ohio must develop systems to identify patients or residents who are in need of palliative care and inform them about the benefits and availability of those services. Other provisions in the law allow inpatient hospice providers to […]