Knowing their rights, risks and responsibilities in the appeal process can be key for hospices to weather a regulatory audit. Hospice providers have grown increasingly concerned about the financial and operational impacts of heightened auditing activity in the industry. Some have faced reimbursement suspension when auditors suspect potential overpayment or fraud. Hospices rely heavily on […]
St. Croix Hospice has acquired Corpore Sano Hospice in Plymouth, Mich., the company’s second location in that state. Financial terms were undisclosed. St. Croix, which is backed by the private equity firm H.I.G. Capital, has been on a growth trajectory for at least the past three years, with a focus on Midwestern markets. In addition […]
Anti-kickback and fraud cases have proliferated as regulators zero in on the hospice industry. How a hospice works with referral sources can be a red flag that brings providers face-to-face with criminal charges in False Claims Act (FCA) cases. FCA suits can include significant legal repercussions for hospice providers such as imprisonment for committing health […]
Hospices have seen a spike in regulatory audits that could intensify as utilization rises. The U.S. Centers for Medicare & Medicaid Services (CMS), their contractors and the U.S. Department of Health & Human Services Office of the Inspector General (OIG) have been digging deeper into the hospice space in recent years, and many hospices are […]
In an evolving payment and regulatory environment, hospices would benefit from stepping up their engagement with federal, state and local agencies and legislators. This may be particularly urgent now, with the public comment period still open on the 2023 proposed payment rule, and as policymakers debate whether COVID-related waivers and assistance should end. Federal agencies […]
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