Both opportunities and challenges exist for hospice providers as regulators zero in on program integrity. Hospices stand to grow their census by taking on patients left behind by “bad actors” in certain markets. However, some fear that regulators’ responses could put a drain on employee retention and margins. Widespread reports of fraud and abuse in […]
The U.S. Department of Health & Human Services (HHS) Office of the Inspector General (OIG) recently announced plans to launch a new audit that will focus on general inpatient hospice services. Longer general inpatient hospice stays and high-cost issues are reasons for the audit, dubbed the “Audit of Selected, High-Risk Medicare Hospice General Inpatient Services,” […]
Hospice providers can face legal repercussions if they don’t strike the right balance in their payroll practices. Miscalculated compensation or miscommunicated policies are among the most common reasons that hospices are facing legal concerns related to staff compensation, according to Russell Bruch, partner at Morgan Lewis. Bruch assists employers with legal wage and salary matters […]
Industry-wide staffing woes are bleeding into hospices’ compliance programs. Many hospices are struggling not only operationally, but also financially to comply with regulations, according to Norbert Hudak, partner at in90Group, a Los Angeles-based business marketing and strategy development company. The company recently polled 100 home health and hospice executives on their biggest quality and compliance […]
Though evidence shows that longer hospice stays reduce costs, providers are still walking a regulatory tightrope. On one hand, longer hospice stays can lead to improved patient and family satisfaction and greater cost saving opportunities. On the other hand, regulators often treat stays longer than six months or frequent recertifications to be red flags that […]
Hospice News connects with Howard Young, Partner at law firm Morgan Lewis, to discuss some of the largest compliance issues hiding in plain sight of hospice leaders. Subscribe to Elevate to receive all of the latest content: Apple PodcastsSoundcloud
As California pursues hospice licensing reform, some providers in other states are watching for similar actions closer to home. In December, California Gov. Gavin Newsom (D) approved legislation that tightened hospice oversight in the state. This includes establishing a moratorium on new hospice provider licenses until the California Department of Public Health (CDPH) sets emergency […]
Regulatory attention heating up in the hospice industry could be impacting buyers’ mergers and acquisitions decisions. Nuances in the regulatory environment can be difficult to navigate, perhaps more so for private equity and venture capital investors that are new to the industry. Changes to federal enforcement practices during the next year could bring some additional […]
The U.S. Department of Health & Human Services (HHS) Office of the Inspector General (OIG) recently began to probe hospices in its initial phase of Provider Relief Fund (PRF) audits. More than two years after the CARES Act established the $175 billion PRF, federal regulators are moving forward on audits that closely examine the ways […]
Knowing their rights, risks and responsibilities in the appeal process can be key for hospices to weather a regulatory audit. Hospice providers have grown increasingly concerned about the financial and operational impacts of heightened auditing activity in the industry. Some have faced reimbursement suspension when auditors suspect potential overpayment or fraud. Hospices rely heavily on […]
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