The U.S. Centers for Medicare & Medicaid Services (CMS) is giving hospices a 3.1% increase to their per diem payments for 2024, according to a final rule published Friday. That will translate to a $780 million bump to hospice payments next year compared to Fiscal Year 2023, according to CMS. The finalized rule also raises […]
A restructuring of the Medicare Hospice Benefit could have impacts on merger and acquisition activity in the industry. Calls for changes to hospice eligibility and length of stay are growing louder among industry stakeholders. A main concern being voiced to the U.S. Centers for Medicare & Medicaid Services (CMS) is that the current six-month prognosis […]
As federal regulators intensify their focus on hospices, operators may begin seeing an influx of Recovery Audit Contractor (RAC) activity. The U.S. Centers for Medicare & Medicaid Services (CMS) contracts with RACs to conduct post-payment reviews designed to recover any funds that may have been overspent. RAC audits can re-examine hospice claims going back as […]
Fraud, waste and abuse issues that have percolated in the hospice space have put providers up against some regulatory walls. Heightened scrutiny around hospice from regulatory agencies is not without warrant, but increased oversight can have adverse effects on the ability to provide quality care, according to Bill Dombi, president, National Association for Home Care […]
The U.S. Centers for Medicare & Medicaid Services (CMS) is conducting a small pilot program for post-payment reviews of hospice stays that exceed 90 days. The agency has contracted with Noridian Healthcare Solutions, LLC as its Supplemental Medical Review Contractor (SMRC). Noridian will perform the reviews and submit findings to CMS. “CMS internal data has […]
The U.S Centers for Medicare & Medicaid Services (CMS) is implementing a “period of enhanced oversight” for new hospices in California, Nevada, Arizona and Texas. A key component of the enhanced oversight includes a medical review of claims before a Medicare Administrative Contractor (MAC) will pay them. These actions follow reports of potentially unethical or […]
Sens. Tammy Baldwin (D-Wisc.) and Shelley Moore Capito (R-W.Va.) have reintroduced the Palliative Care and Hospice Education Training Act (PCHETA), designed to bolster the field’s shrinking workforce with federal support. If enacted, PCHETA would support hospice and palliative care training programs for physicians, nurses, pharmacists, social workers and chaplains. The bill would also expand continuing […]
Increased regulatory and clinical oversight is needed to address common billing and documentation errors related to hospice general inpatient care, according to the U.S. Department of Health & Human Services (HHS) Office of the Inspector General (OIG). Inaccurate billing was among the driving forces behind the OIG’s recently announced nationwide audit of general inpatient hospice […]
Hospices need to have solid documentation to demonstrate a patient’s need for general inpatient care (GIP) as regulatory oversight zeroes in on those services. GIP can involve longer stays and higher costs. For these reasons, the U.S. Department of Health & Human Services (HHS) Office of the Inspector General (OIG) is launching a new audit […]
Individuals in several states have been securing hospice licenses only to turn them around in a quick sale. A number of these hospices are accredited, prompting calls for greater oversight of organizations with deeming authority. A surge of newly licensed hospices has swelled in California, Arizona, Texas and Nevada. Many of these have been accused […]
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