An evolving regulatory landscape may be complicating hospices’ ability to effectively implement and use artificial intelligence technology. The top legal considerations involving AI center around protecting patient privacy and ensuring transparent innovation. Hospices have leveraged AI to better predict patient trajectories, ease employees’ administrative burden, boost retention, and improve compliance and operational efficiency, among other […]
Auditors are raising new questions around two common issues in hospices’ Medicare claims — documentation supporting patient eligibility and the physician narrative. Program integrity issues and quality concerns have raised the bar of regulatory oversight in recent years, with auditing activity ramping up as more providers undergo multiple audits simultaneously each year. New documentation red […]
Newly launched or acquired hospice businesses have come under a finer regulatory microscope in recent years as regulators respond to fraudulent activity in the space. Some legitimate hospices may be buckling under ramped up regulatory pressures that have impacted their financial sustainability. The U.S. Centers for Medicare and Medicaid Services’ (CMS) regulatory oversight approach could […]
Recent court rulings have the potential to make significant differences in the landscape of hospice regulatory oversight in coming years, particularly when it comes to audits and the forthcoming Special Focus Program (SFP). In June the U.S. Supreme Court overturned a ruling that in 1984 established the “Chevron Doctrine,” which instructed lower courts to defer […]
Hospices need to understand the range of risks involved in qui tam cases and how best to navigate whistleblower concerns amid an evolving regulatory landscape. Qui tam actions occur when a whistleblower, called a “relator” by the courts, files a False Claims Act suit on behalf of the government. The relator has the potential to […]
Unified Program Integrity Contractor (UPIC) auditors are taking a sharper look at nursing home room-and-board for hospice patients. Hospices have increasingly faced more regulatory scrutiny in recent years amid rising program integrity concerns, including ramped up UPIC audits, among various others. These audits are designed to instill oversight measures aimed at safeguarding against bad actors […]
Trust and collaborative communication are essential to hospice executive teams seeking to weather a changing health care system. This is according to HopeHealth President and CEO Diana Franchitto and the company’s CMO Dr. Edward Martin. Franchitto and Martin have led the organization for roughly 15 years. The nonprofit health system provides home care, hospice, palliative […]
Increased technology utilization in end-of-life care has come with innovative care delivery opportunities alongside cybersecurity risks. Hospices have widened the breadth of ways they leverage technology including artificial intelligence-assisted (AI) patient therapies to boost quality and use of predictive analytics to improve access and length of stay. Additionally, hospice providers have also integrated various electronic […]
Nonprofit hospices can combine their businesses in a number of ways, including traditional acquisitions, board member substitutions and other types of affiliations. However, member substitutions are becoming more common, according to Meg Pekarske, partner at the law firm Husch Blackwell. While this model offers benefits it can also become a political minefield that can sink […]
In case you missed it, Hospice News has launched a new specialty publication for palliative care professionals. You can subscribe to Palliative Care News here: Subscribe today! Ensuring staff are educated around revisions to hospice survey processes will be key to navigating ongoing regulatory changes in the industry. Revisions to hospice surveys have been in the pipeline […]
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