Hospice Industry Seeks Solutions to Issues in OIG Reports

Debate continues about how the hospice industry, as well as regulators, should respond to the reports on hospice care issued in July by the U.S. Department of Health and Human Services Office of the Inspector General (OIG) that included recommendations to the U.S. Centers for Medicare & Medicaid Services (CMS) on changing their processes for […]

MedPAC Mulls 20% Cut to Hospice Payment Cap

The Medicare Payment Advisory Commission (MedPAC) is considering a recommendation that Congress reduce by 20% the annual aggregate payment cap for hospice care. Also under consideration is a potential recommendation to adjust the cap according to the wage index for different geographic regions to reflect the varying costs of care in different parts of the […]

Hospice Legislation Comes Closer to House Vote

The number of cosponsors for the Palliative Care and Hospice Education and Training Act has reached the 290 the bill needs to come to a vote in the U.S. House of Representatives. A second bill, the Rural Access to Hospice Act, will likely be folded into a larger yet-to-be-determined piece of legislation. If enacted, PCHETA […]

Hospice Outreach to Minorities Could Save Medicare $270 Million

Addressing long-standing racial disparities in hospice care could save Medicare as much as $270 million annually, new research has found. Outreach to underserved communities can ensure more patients receive quality care at the end-of-life as well as open untapped markets to hospice providers. “We all know the quality of life benefits but seeing the economic […]

Modernizing the Medicare Hospice Benefit

The Medicare Hospice Benefit is aging along with the patients it is designed to serve. Nearly 40 years since its inception, it may be time to re-examine aspects of the program in light of the ways that patient populations and the larger health care system have changed.  The hospice benefit was established as a demonstration […]

Hospice Margins Could Soar Under Primary Care First

Hospice providers that participate in the Primary Care First initiative’s Seriously Ill Population Model could see gross margins in excess of 20% to 25%, according to experts in health care payment models. The U.S. Centers for Medicare & Medicaid Services (CMS) in April announced that they would implement Primary Care First in phases beginning in […]

Court: Difference of Opinion is Not Hospice Fraud

The Eleventh Circuit Court of Appeals partially affirmed a decision in favor of Arkansas-based hospice provider AseraCare in False Claims Act (FCA) case that has widespread implications for the hospice industry. The appellate court agreed with the Northern District of Alabama that a mere difference of physician’s opinions on a terminal patient’s prognosis does not […]

Hospice to OIG: Medication Billing Not So Simple

Federal watchdogs recently called out the hospice industry on medication billing practices on the grounds that Medicare was paying twice for some drugs, but many hospices feel they lack clear direction as to what should be covered as they contend with the inherent complexity of diagnostic processes. Hospices nationwide billed Medicare Part D a combined […]

MA Carve-In Could Forego 6-Month Prognosis Rule for Hospice

Medicare Advantage plans would not necessarily be bound by Medicare’s six-month terminal prognosis requirement under a forthcoming hospice carve-in. Medicare Advantage plans are offered by private insurance companies approved by CMS, and include HMO, PPO, and fee-for-service plans among other options. The program represents an integrated care model that is designed to promote coordination of […]

Florida Expected to Take Hardest Hit in Hospice Staff Shortage

Ongoing workforce shortages in the hospice space are expected to worsen, with Florida taking the biggest hit due to the size of its population older than 65.  The number of hospice and palliative care physicians and members of other disciplines will drop precipitously during the next two decades, largely due to retirements and staff leaving […]