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 […]
The U.S. Centers for Medicare & Medicaid Services (CMS) has released its final guidance manual for implementing the Hospice Outcomes and Patient Evaluation (HOPE) tool. The tool is slated for an October 2025 implementation, according to the agency’s 2025 final hospice rule. The tool will replace the Hospice Item Set (HIS) quality reporting system. In […]
The U.S. Centers for Medicare & Medicaid Services (CMS) is expanding its enhanced oversight for new hospices in fraud-ridden states, including California, Nevada, Arizona and Texas. The agency in July 2023 first announced a “provisional period of enhanced oversight” for new hospices in those states. A key component of the enhanced oversight includes a medical […]
Efforts to establish potential payment mechanisms for high-acuity palliative services within the Medicare Hospice Benefit will require greater clarity from regulators, according to the Coalition to Transform Advanced Care (C-TAC). The U.S. Centers for Medicare & Medicaid Services’ (CMS) 2025 proposed hospice payment rule contained a request for information (RFI) on the potential implementation of […]
The U.S. Centers for Medicare & Medicaid Services’ (CMS) has launched the Guiding an Improved Dementia Experience (GUIDE) payment model with close to 400 participating organizations, including many palliative care providers. The CMS Innovation Center announced the GUIDE demonstration in July 2023. The payment model is designed to improve quality of life for dementia patients […]
The U.S. Centers for Medicare & Medicaid Services (CMS) has updated its guidance on the recently implemented hospice certifying physician Medicare enrollment requirement. The revisions were fueled by mounting concerns that the requirement posed potential compliance issues. The requirement stipulated that physicians who certify hospice services must enroll in or opt out of Medicare by […]
The U.S Centers for Medicare & Medicaid Services (CMS) has announced a second cohort for its Enhancing Oncology Model payment demonstration, as well as some updates to the program. The goals of the Enhancing Oncology Model (EOM), which went live on July 1, are to improve quality and reduce the cost of cancer care with […]
Members of Congress are demanding answers from the U.S. Centers for Medicare & Medicaid Services (CMS) on continuing evidence of hospice fraud and quality issues. Reps. Beth Van Duyne (R-Texas) and Earl Blumenaur (D-Ore.) led a coalition of 38 congressional lawmakers who in a letter asked CMS for further information on how the agency intends […]
The U.S. Centers for Medicare & Medicaid Services (CMS) has delayed the implementation of hospice certifying physician Medicare enrollment requirements. CMS delayed the date to enroll in or opt out of Medicare until June 3 for physicians who certify hospice services. Stipulated in the 2024 hospice payment rule and part of the Affordable Care Act, […]
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