The U.S. Centers for Medicare & Medicaid Services (CMS) has made public its first cohort for the hospice Special Focus Program (SFP). Finalized in the 2024 home health payment rule, the program is designed to identify poor performing hospices, mandate quality improvement and in some cases impose additional penalties. However, stakeholders in the hospice space […]
The U.S. Centers for Medicare & Medicaid Services (CMS) recently elaborated on its plans to expand public education campaigns designed to help protect hospice beneficiaries from fraudulent actors in the space. Program integrity concerns have heated up in the hospice industry. Swarms of new hospices have emerged in certain regions in recent years, with some […]
Palliative care providers that form collaborative partnerships with Accountable Care Organizations (ACOs) may be lending to a landmark downward trend in health care spending in the value-based payment landscape. The U.S. Centers for Medicare & Medicaid Services (CMS) recently announced that its Medicare Shared Savings Program (MSSP) yielded more than $2.1 billion net savings in […]
The U.S. Centers for Medicare & Medicaid Services (CMS) recently expanded tribal health care reimbursement options in state-based and pediatric programs. The move could help palliative care providers improve access and disparities among underserved indigenous populations. CMS has approved coverage amendments that allow certain state Medicaid programs and Children’s Health Insurance Programs (CHIP) to cover […]
A California-based physician is suing the U.S. Department of Health & Human Services (HHS) and the U.S. Centers for Medicare & Medicaid Services (CMS) in response to fraud allegations that have resulted in licensure and billing privilege revocation. Dr. Rami Moustafa Shaarawy recently filed a civil action lawsuit against HHS, CMS and Noridian Healthcare Solutions […]
Hospices have grown increasingly frustrated by fraudulent operators in the space and how their activities affect legitimate operators’ financial health. This is the second of a two-part Hospice News series that explores how fraud, waste and abuse in the hospice space could create headwinds for the industry at large. Fraudsters misspend millions of Medicare dollars […]
The U.S. Centers for Medicare & Medicaid Services (CMS) recently released new guidelines intended to better support state-based pediatric reimbursement systems and help improve equitable health access among youth populations. The new guidance includes best practices for state Medicaid programs and the Children’s Health Insurance Program (CHIP) to implement and comply with early and periodic […]
Fraudulent operators in the hospice space have misspent millions of Medicare dollars in recent years. This problem has become so severe that it has become one of the defining issues facing the hospice industry, with providers and other industry stakeholders expressing concern about significant impacts to future payment, access, sustainability and utilization. This is the […]
Growth in the number of Medicare Advantage beneficiaries will likely overtake that for traditional Medicare in 2025, according to new estimates from the U.S. Centers for Medicare & Medicaid Services (CMS). The agency projects that total MA enrollment will reach 35.7 million people following the open enrollment period slated to begin later this month, representing […]
The Center for Medicare & Medicaid Innovation’s (CMMI) Kidney Care Choices (KCC) Model demonstration has increased utilization of dialysis in the home and has fostered greater clinician training in addressing related conditions. However, more time and data are needed to evaluate the reimbursement model’s impact on quality and cost, according to the first annual model […]
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