Some legal and technology experts have grown increasingly concerned by a potential lack of human oversight in artificial intelligence-assisted hospice regulatory enforcement. The AI-driven efforts to crackdown on fraudulent activity could bring significant impacts for legitimate providers, including risk of revocation and closure. In the first of a two-part series, Hospice News sits down with […]
Current hospice requirements may be misaligned with the needs of today’s patients and their families, according to regulatory and legal experts. The issue has hospice providers grappling with compliance challenges. Established in 1983 through the Tax Equity and Fiscal Responsibility Act (TEFRA), the Medicare Hospice Benefit created a regulated reimbursement for interdisciplinary end-of-life care. Though […]
The U.S. Centers for Medicare & Medicaid Services (CMS) has been largely unresponsive to hospices’ rebuttals to payment suspensions due to suspicion of fraud. Legitimate hospice providers are being swept into CMS’ broader fraud crackdown, with some agencies reportedly facing payment suspensions severe enough to force closures. As of May 13, the agency said it […]
Legitimate hospice providers are likely being caught up in the U.S. Centers for Medicare & Medicaid Services’ (CMS) crackdown on fraud, including through payment suspensions that are leading to some agency closures. That’s according to several provider executives and industry leaders who have spoken to Hospice News in recent days, as news this week ratcheted […]
Rumors have circulated that the U.S. Centers for Medicare & Medicaid Services (CMS) is mulling a national moratorium on hospice provider enrollment in Medicare, stirring some debate in the provider community. To date, CMS has not made any public statements about a moratorium. However, sources in Washington relayed rumours to Hospice News that such an […]
The U.S. Centers for Medicare & Medicaid Services (CMS) is casting a wide net in its anti-fraud efforts, and some legitimate providers are finding themselves on the hook. Widespread hospice fraud has been documented in several states. Some providers have enrolled patients who did not qualify for hospice care or did so without the patients’ […]
Utah-based Summit Hospice has agreed to settle allegations of False Claims Act violations for $1.05 million. The U.S. Department of Justice indicated that claims resolved by the settlement are allegations only and liability was not determined. The U.S. Attorney’s Office for the District of Utah investigated the allegations, along with the state’s Medicaid Fraud Control […]
