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Federal Officials Call for Stronger Medicare Advantage Oversight

Hospice News

Congressional legislators are casting doubts on regulatory oversight of Medicare Advantage plans over concerns about spending, claims denials, and end-of-life care. Department of Health & Human Services Office of the Inspector General (OIG), the Medicare Payment Advisory Commission (MedPAC), and the Government Accountability Office.

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M&A Volume May Shift From Hospice to Home Health

Hospice News

Centers for Medicare & Medicaid Services (CMS) has honed in on hospice program integrity through a number of new regulations, including some in the agency’s 2024 hospice final rule. The regulations focused on Medicare enrollment in an effort to stifle unethical or illegal activity in the space.

2024 147
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NAHC President Bill Dombi: History Repeating Itself on Hospice Program Integrity

Hospice News

Centers for Medicare & Medicaid (CMS) this year introduced a number of new regulations, many of which were modeled after some in place for home health agencies and skilled nursing facilities. Back in the 1990s, the microscope ended up focusing on the Medicare Home Health Program.

Webinar 299
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What Hospices Can Learn from Home Health Agencies on New Program Integrity Rules

Hospice News

Hospices seeking to gauge the potential impact of new regulatory actions in the space can look to their counterparts in the home health field. CMS is no doubt hoping for similar results for the Medicare Hospice Benefit. Their recommendations included a temporary moratorium on new hospices enrolling in Medicare.

Hospice 246
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CMS Proposes ‘36-Month Rule’ to Curb Hospice License ‘Flipping’

Hospice News

Some of these providers have secured licenses, as well as Medicare certification and, sometimes, accreditation. They then proceed to enroll a small number of patients for whom they never bill Medicare, multiple hospice executives told Hospice News on background. By not billing, they are better able to avoid regulators’ attention.

Hospice 255
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Pennant Group Acquires Guardian Hospice

Hospice News

Guardian Hospice of Oklahoma received Medicare certification in 2015 and has since grown its presence in the state and across Texas. The company operates 102 hospice and home health locations and 51 senior living communities in 13 states, including Texas and Oklahoma. Centers for Medicare & Medicaid Services (CMS).

Hospice 263
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Three Key Gauges of Hospice Business Performance

Hospice News

Medicare Administrative Contractor (MAC)] audits and those sorts of things add overhead expenses, and those indirect costs are going to be something that we all will have to deal with. Because as more [Accountable Care Organizations (ACOs), Medicare shared-savings health plans negotiate with hospices, they’re going to want a discount.”.

Hospice 246