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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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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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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. Close to 12 million people in the United States qualify for both Medicare and Medicaid. Some hospice patients rely on these plans for other health needs, such as nursing home costs.

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

Hospice News

Centers for Medicare & Medicaid Services (CMS) requires operators to report incidents of patient abuse and neglect that involve their staff. This would bring the hospice rules in line with those used in long term care. Government Accountability Office (GAO) has recommended. NAHC also called on the U.S.

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Therapy teams take note: CY 2023 Medicare Physician Fee Schedule Final Rule

Rehab Realities by Renee Kinder

Medicare has released the calendar year 2023 final rule related to Medicare Part B, which is impacted by the physician fee schedule and determines rates and coding updates for your rehab providers. Click here for a fact sheet on final changes to the Medicare Shared Savings Program. Renee Kinder. It’s that time of year again!

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

Hospice News

A leading cause of fraud involves hospices billing Medicare for services for which patients were not eligible, according to a 2021 report from Bass, Berry, & Sims. Two OIG reports in 2019 shook the industry with findings that condition-level deficiencies posed safety risks to patients.

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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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