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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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Why Skilled Nursing, Assisted Living Operators Invest in Home-Based Hospice Programs

Hospice News

Offering hospice can be a gamechanger for skilled nursing and assisted living operators looking to stand out from competitors and improve patient reach. Home-based care, including hospice, has become an increasingly attractive space for facility-based health care providers of all walks. Among the 1.6

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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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Hospice Medical Director Receives 50-Month Prison Sentence for $150M Fraud

Hospice News

A federal judge has sentenced Jesus Virlar-Cadena, formerly a medical director for the Texas-based hospice company Merida Group, to 50 months in prison for his role in a $152 million scheme. The Texas Medical Board suspended his medical license in 2019, when he pleaded guilty to the fraud charges.

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Hospices Acquired by PE Firms, Publicly Traded Companies See Increases in Dementia Patients

Hospice News

Hospices tend to see an increase in dementia patient admissions as well as home-based utilization following an acquisition by a private equity firm or a publicly traded company. After an acquisition by a public company, hospices saw a 1.4% A little more than 20% of hospice decedents in 2020 suffered from dementia, up from 18.5%

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Hospice Length of Stay: Balancing Patient Needs Against Regulatory Compliance

Hospice News

Though evidence shows that longer hospice stays reduce costs, providers are still walking a regulatory tightrope. On one hand, longer hospice stays can lead to improved patient and family satisfaction and greater cost saving opportunities. Are you in an outlier scenario with your data that Medicare contractors are looking at?

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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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