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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. These “unrelated” payments have been soaring.

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GAO: CMS Should Update Rules for Hospices Reporting Abuse or Neglect

Hospice News

Hospices should be required to report all instances of abuse and neglect, even if the perpetrator was not an employee, the U.S. Centers for Medicare & Medicaid Services (CMS) requires operators to report incidents of patient abuse and neglect that involve their staff. Government Accountability Office (GAO) has recommended.

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How Palliative Care Could Help Break the SNF-to-Hospital Cycle

Hospice News

A dearth of coordination or integration between rehab teams and palliative care teams routinely forces some patients into a cycle between the hospital and the nursing home in their last year of life. These results appeared in a 2019 New England Journal of Medicine study titled “Rehabbed to Death.”

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Regulatory Focus in Hospice Giving Buyers Pause in M&A Deals

Hospice News

Regulatory attention heating up in the hospice industry could be impacting buyers’ decisions/how buyers move forward with mergers and acquisitions in the space. The nuances involved in the regulatory environment around hospice can be difficult to navigate for private equity and venture capital investors that are new to the industry.

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CMS to Sunset Look-Alike Dual-Eligible Special Needs Plans in 2023

Hospice News

Centers for Medicare & Medicaid Services (CMS) in 2023 will phase out dual-eligibility special needs look-alike plans within Medicare Advantage. Some hospice patients rely on these plans for other health needs, such as nursing home costs. Close to 12 million people in the United States qualify for both Medicare and Medicaid.

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Impact of Section GG, ANAs and Social Risk Factors (SRFs) on PAC outcomes

Rehab Realities by Renee Kinder

The Centers for Medicare & Medicaid Services has contracted with Acumen LLC and Abt Associates to develop quality and cost measures for use in the IRF, LTCH, SNF, and HH QRPs and the Nursing Home Quality Initiative (NHQI). What was this group’s aim you ask? Project Overview.

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Patient and family engagement — understanding CoreQ

Rehab Realities by Renee Kinder

On April 11, 2022, the Centers for Medicare & Medicaid Services issued a proposed rule that would update Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System for fiscal year 2023. . Renee Kinder. Ready to learn more?