Hospice Leaders: Change Must Come to the Medicare Benefit

Calls have grown louder for an overhauled design of the Medicare Hospice Benefit, but the path towards change is riddled with contrasting views over regulation, policy and payment structures. Hospice providers are hitting financial and regulatory walls when it comes to sufficiently covering the spectrum of services necessary to care for patients and families, according […]

Congress Members Call on CMS to Revise Proposed Hospice Special Focus Program

Four members of Congress led by Reps. Beth Van Duyne (R-Texas) and Earl Blumenauer (D-Oregon) have called for changes to the forthcoming Special Focus Program (SFP) from the U.S. Centers for Medicare & Medicaid Services (CMS). Jimmy Panetta (D-CA) and Brad Wenstrup (R-OH) were also signatories on the letter to CMS Administrator Chiquita Brooks-LaSure and […]

Understanding CMS’ Civil Monetary Penalties for Hospices

The U.S. Centers for Medicare & Medicaid Services (CMS) has been gradually implementing changes to the hospice survey process and enforcement remedies, including civil monetary penalties in some instances. Congress approved the survey changes and enforcement actions through the Consolidated Appropriations Act of 2021, which incorporated language from the Helping Our Senior Population in Comfort […]

CMS’ Proposed Method of Selecting SFP Hospices May Be Flawed

While the hospice community has generally embraced the concept of a Special Focus Program (SFP) to address quality concerns, some are troubled by the government’ methodology for identifying providers. The U.S. Centers for Medicare & Medicaid Services (CMS) plans to launch the program in 2024, according to language included in the agency’s proposed home health […]

How the 4 Largest Hospice Industry Groups Work Together to Support Program Integrity

The four largest hospice industry organizations have been working to present a united front to address widespread program integrity issues. As those problems proliferate, the National Hospice and Palliative Care Organization (NHPCO), the National Association for Home Care and Hospice (NAHC), LeadingAge and the National Partnership for Healthcare and Hospice Innovation (NPHI) have been speaking […]

Building a Palliative Care-Focused ACO

Accountable Care Organizations (ACO) represent a growing opportunity for palliative care companies, and providers have a number of ways to get in on the ground floor. Along with Medicare Advantage, ACOs are one of the few avenues towards more robust reimbursement than fee-for-service models. Operators can come to ACOs by two main avenues. For one, […]

The Role of Medicare Advantage in Growing Palliative Care Services

For the time being, Medicare Advantage may be providers’ best bet for palliative care reimbursement. The U.S. Centers for Medicare & Medicaid Services (CMS) also allows Medicare Advantage plans to cover palliative care as a supplemental benefit. In addition, the agency has integrated palliative care components into the Value-Based Insurance Design Model (VBID), often called […]