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Hospice Leaders: Change Must Come to the Medicare Hospice Benefit

Hospice News

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. Part of the problem is that the [Medicare] Hospice Benefit is 40 plus years old. of terminal diagnoses in 2020, while cancer accounted for 7.2%.

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OIG Estimates $42 Million in Improper Medicare Payments for Advance Care Planning

Hospice News

million in improper payments in 2019. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently reported the results of its audit of advance care planning (ACP) billing practices among Medicare-certified physicians and other health care providers. OIG has already recommended that the U.S.

Medicare 215
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Medicare Claims for Unrelated Services Put Hospices at Risk

Hospice News

Medicare claims for unrelated services creates serious financial and legal risks for hospice providers — even if they are not the ones who sent the bill. During recent years, payouts for non-hospice services provided to Medicare beneficiaries have tipped into the billions. Centers for Medicare & Medicaid Services (CMS).

Medicare 237
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Hospice Advocacy Groups Ask Congress for Action on Proposed 2023 Medicare Rates

Hospice News

bump in Medicare payments, which they say is insufficient in light of COVID-19 and staffing headwinds. A key point of contention is that CMS used 2019 data to calculate the 2023 rate, including wages and cost reports. More than a dozen hospice advocacy groups have called on congressional leadership to intervene in a proposed 2.7%

Medicare 226
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Canon Healthcare Owner Receives Prison Sentence, $42 Million Fine in Fraud Case

Hospice News

The court also ordered Akula to repay $42 million in fraudulent Medicare billing claims made between January 2013 and December 2019, which totaled roughly $84 million during that six-year span. The charges included fraudulent claims for physician services and home visits, as well as manipulation of Medicare billing codes.

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CMS to Sunset Hospice VBID in 2024

Hospice News

Centers for Medicare & Medicaid Services will end the hospice component of the value-based insurance design model (VBID) as of Dec. Often called the “hospice carve-in,” the program was designed to test coverage of hospice care through Medicare Advantage, in addition to some coverage of palliative care and transitional care.

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Congress Mulls Bill to Extend Recertifications by Telehealth

Hospice News

Centers for Medicare & Medicaid Services (CMS), they would not be able to recertify via telehealth. Also, clinicians who are not enrolled in Medicare or who validly opted out would likewise be prohibited. Researchers conducted 88 concurrent in-person and telehealth visits between June and November 2019.

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