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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).

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Congress Grills HHS on Hospice Program Integrity

Hospice News

Members of Congress are raising questions about the continued Medicare certification for new hospices in areas rife with fraud. Investigations have shown that potentially hundreds of newly licensed hospices have bilked Medicare of millions of dollars during the past several years, all while providing egregiously poor care or none at all.

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SCAN Group CEO Sachin Jain: Medicare Could Use a Major Facelift

Hospice News

The mission and function of the Medicare program have evolved over time, and the agency that runs it also may need to adapt to the new ways that health care organizations are doing business, according to SCAN Group CEO Dr. Sachin Jain. billion nonprofit Medicare Advantage (MA) organization that covers more than 270,000 members.

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Research Points to Palliative Care’s Underutilization Among Cancer Patients

Hospice News

The researchers examined Medicare claims data of beneficiaries 65 and older with recent cancer diagnoses who were given a six-month life expectancy prognosis between 2010 and 2019. Patients included those with advanced stage breast, colorectal, non-small cell lung (NSCL), small cell lung (SCL), pancreas and prostate cancer.

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Hospices’ Mythbusting Strategies: ‘It’s Not Brink-of-Death Care’

Hospice News

Nearly half, or 49.1%, of all Medicare decedents utilized hospice services in 2022, reported the National Alliance for Care at Home. National hospice utilization rates have hovered around this vicinity for the past decade, with 44% of decedents receiving these services in 2010, the Alliance report found.

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Tapestry Hospice Execs Settle Fraud Case for $1.4M; Prison Term, $3M Penalty in Angel Care Case

Hospice News

Dr. David Lovell, its founder and owner, launched the for-profit hospice in 2010, and the enterprise became Medicare-certified in 2012. million in improper Medicare claims. Justice Department, Angel Care enrolled 24 patients in hospice between 2009 through 2017 who did not meet Medicare eligibility requirements.

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Gentiva Settles FCA Claims Against Kindred at Home

Hospice News

The federal government and the State of Tennessee first filed these complaints against Kindred in 2021 for claims submitted between 2010 and 2020. Gentiva’s parent company, the private equity firm Clayton, Dublier and Rice, acquired a 60% stake Kindred at Home’s hospice assets in 2022 for $2.8 million, with previous owner Humana Inc.

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