A coalition of industry groups has spoken out about the design of the U.S. Centers for Medicare & Medicaid Services (CMS) forthcoming Special Focus Program (SFP) for hospices. CMS initially pitched the idea in 2022 but instead convened a Technical Expert Panel (TEP) to further guide development. The TEP completed its work late last year, […]
As Jimmy Carter marks his sixth month in hospice care, the provider community is raising awareness by saluting the former president. The National Hospice and Palliative Care Organization (NHPCO) convened a group of hospice leaders at Times Square in New York City to commemorate Carter’s hospice experience. Some hospice executives have said they believe that […]
Flaws exist in the U.S. Centers for Medicare & Medicaid Services’ (CMS) auditing processes, a coalition of industry organizations indicated in a letter to the agency. The organizations pointed to “fundamental, long-standing” problems pertaining to the audit focus areas, overpayment recovery and adjudication processes, as well as auditor consistency and education. The organizations included LeadingAge, […]
Hospices seeking to gauge the potential impact of new regulatory actions in the space can look to their counterparts in the home health field. The steps that the U.S. Centers for Medicare & Medicaid Services (CMS) has put forth to strengthen hospice program integrity mirror rules implemented in years past for home health providers, including […]
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 […]
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 health care space — including hospice — is increasingly shaped by numbers. During the past several years hospice providers have had to become experts in data management in order to remain competitive. Data has become invaluable to negotiations with referral and payer sources, as well as to regulatory compliance. But providers can also benefit […]
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 […]
Some hospice owners have been selling their businesses soon after securing a license. This has prompted federal agencies to pursue new regulations to address the problem. The practice appears to stem from a rash of newly licensed hospices that have emerged in California, Nevada, Texas and Arizona. Some of these providers have secured licenses, as […]
The U.S. Centers for Medicare & Medicaid Services (CMS) has proposed a requirement that would prohibit hospice owners from selling their businesses within 36 months of Medicare enrollment. The agency included these plans in its proposed home health rule for 2024. This is the latest step in the agency’s efforts to improve hospice program integrity […]
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