The post-Medicare Advantage hospice carve-in landscape could include wider value-based reimbursement avenues in the hospice space, leading providers to pivot into MA payer relationships. The forthcoming end of the hospice component of the value-based insurance design (VBID) demonstrative takes effect Dec. 31. Launched in 2021, the carve-in was designed to test coverage of hospice care […]
National Association for Home Care and Hospice
Regulators are sharpening their focus on several aspects of hospice quality data to help weed out fraud, waste and abuse. Hospice Quality Reporting Program (HQRP) requirements have seen an overhaul in recent years as the U.S. Centers for Medicare & Medicaid Services (CMS) works to curb malfeasance in the industry. Program integrity concerns have been […]
The Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act, if enacted, would make changes to the ways hospices provide respite care. Rep. Earl Blumenauer (D-Oregon) is in the process of drafting the bill that would represent the most significant reforms to date for hospice payment and oversight. The legislation is currently in a discussion […]
The U.S. Centers for Medicare & Medicaid Services (CMS) on Tuesday finalized its 2025 hospice payment rule, but some say that the base rate increase is insufficient in today’s environment. CMS approved a 2.9% raise in per diem hospice payments, which is higher than the 2.6% the agency initially proposed. Stakeholders in the space contend […]
The Medicare Hospice Benefit is ripe for change nearly four decades after its establishment, but moving the needle will include a heavy lift around evolving regulations. This is according to Bill Dombi, president of the National Association for Home Care & Hospice (NAHC). The hospice industry is undergoing tremendous changes amid rising demand and increased […]
Rep. Earl Blumenauer (D-Oregon) is drafting a landmark bill that, if enacted, would represent the most significant reforms to date for hospice payment and oversight. Blumenauer announced the bill, the Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act, on Thursday at the Hospice News Elevate conference in Washington D.C. Though the bill language is […]
Fraudulent hospices continue to proliferate, and some may be moving between states to escape regulators. Beginning in 2021, numerous reports emerged of unethical or illegal practices among hundreds of newly licensed hospices, particularly among new companies popping up in California, Texas, Nevada and Arizona. Thus far, California is the only state to take action on […]
Some accreditation organizations (AOs) have balked at the U.S. Centers for Medicare and Medicaid Services’ (CMS) proposed rule designed to strengthen oversight of those institutions. CMS in February released a proposed rule that would introduce a number of provisions aimed at avoiding conflicts of interest and establishing more consistent standards, processes and definitions among accreditation […]
The U.S. Centers for Medicare & Medicaid Services’ (CMS) proposed 2025 hospice rule contains clarifications on which physicians may certify patients for hospice enrollment. According to language in the proposal, designated physician members of the hospice interdisciplinary team may certify patients for hospice if the medical director is unavailable. The clarification was intended to reconcile […]
The U.S. Centers for Medicare & Medicaid Services’ (CMS) 2025 proposed hospice rule contained requests for information (RFIs) that could signal changes in the agency’s thinking on key issues. Through RFIs, CMS tries to take the pulse of providers’ positions on certain questions that could impact the Medicare Hospice Benefit. In its 2025 proposal, one […]