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. Centers for Medicare & Medicaid Services (CMS) or any Medicare Advantage plans spoke at this hearing.

How Medicare Budget Neutrality Impacts Hospice Payment

Hospice News

Medicare reimbursement is the lifeblood of hospice providers, and a clear understanding of policies like budget neutrality can help elucidate the payment systems that keep their businesses running. But a similar move within the Medicare Hospice Benefit is unlikely.

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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.

Small Hospices at a Disadvantage in Medicare Star Ratings

Hospice News

Centers for Medicare & Medicaid Services’ (CMS) star ratings system for hospice quality may have unintended consequences for small providers. The post Small Hospices at a Disadvantage in Medicare Star Ratings appeared first on Hospice News. The U.S

Incoming Samaritan CEO Phillip Heath: Reduce Dependence on Medicare

Hospice News

One is how can we continue to diversify our services and help more people in more ways — and second, looking at how we can reduce our dependence on Medicare reimbursement. Why is it important to reduce that dependence on Medicare reimbursement?

MEDICARE PART B PREMIUMS TO DECREASE IN 2023

Elder Care Matters

Medicare Part B Premiums to Decrease in 2023 For the first time in over a decade, the Centers for Medicare and Medicaid Services announced that Medicare beneficiaries will enjoy a lower premium in 2023.

How an Advance Care Planning Bill Could Impact Hospice and Medicare

Hospice News

and Susan Collins (R-Maine) introduced the Improving Access to Advance Care Planning Act to the Senate designed to promote greater access to those services among Medicare beneficiaries. Sunsetting the co-pays could cost Medicare roughly $104.5

Hospice, Palliative Care Groups Call for Telehealth Codes on Medicare Claims

Hospice News

A coalition of hospice and palliative care industry groups has urged lawmakers to make billing codes for telehealth available on Medicare hospice claim forms. The post Hospice, Palliative Care Groups Call for Telehealth Codes on Medicare Claims appeared first on Hospice News.

Does Medicare and Supplemental Insurance Pay for Long-Term Care?

Elder Care Matters

I’m often surprised how many people are shocked to learn that Medicare and Supplemental Insurance does not cover Long-Term care costs. Medicare and Supplemental… The post Does Medicare and Supplemental Insurance Pay for Long-Term Care?

Hospice Advocacy Groups Ask Congress for Action on Proposed 2023 Medicare Rates

Hospice News

bump in Medicare payments, which they say is insufficient in light of COVID-19 and staffing headwinds. The post Hospice Advocacy Groups Ask Congress for Action on Proposed 2023 Medicare Rates appeared first on Hospice News.

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Medicare Part A to Run Deficit in 2028, Two Years Later than Expected

Hospice News

The Medicare Part A trust fund is still on track to run short of money before the decade is out, but not as quickly as previously anticipated. By 2028, Medicare would have sufficient dollars to cover 90% of Medicare expenses. Centers for Medicare & Medicaid Services (CMS).

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Significant Change in Medicare Enrollment Risk Categories for SNFs

Healthcare Law Insights blog

Chapter 10 of PIM sets out the instructions by CMS to the MACs for Medicare enrollment. Post-Acute Care & Nursing Facilities Centers for Medicare and Medicaid Services Change of Ownership Senior Nursing Facilities

Save Money by Evaluating your Medicare Plan

Today's Caregiver

The National Council on Aging (NCOA), the national voice for every person's right to age well, is encouraging all individuals with Medicare to evaluate their coverage during this year's Open Enrollment, which runs from October 15 through December 7

Get ready! Medicare’s Open Enrollment starts October 15

Today's Caregiver

You can enroll in Medicare health and drug plans from October 15 – December 7. Get ready for Medicare’s Open Enrollment with these 5 tips

Difference Between Private Duty Care & Medicare Home Care

Comforcare Home Care

There are significant differences between the type of care available through private duty home care agencies and Medicare/Medicaid government funded home care services. Doctor Order Required - Medicare YES Private Duty NO. Length of Service - Medicare 30-60 Days Private Duty Unlimited.

How to bill Medicare Advantage plans in home health and hospice

HEALTHCARE first

Medicare Advantage plans have become an increasingly popular choice among the nation’s seniors. In fact, there are 3,834 Medicare Advantage plans available nationwide for individual enrollment in 2022.

Hospice Myth Buster: Hospice Benefit and Medicare Coverage

Hospice Promise

Electing the Hospice Benefit DOES NOT eliminate Medicare coverage. All other care will continue to be covered under Medicare or other existing insurance coverage. The post Hospice Myth Buster: Hospice Benefit and Medicare Coverage appeared first on Hospice Promise.

Medicare Gives Hospice a Larger Pay Raise than Expected, but Less than Needed

1-800-HOSPICE

On July 27, the Centers for Medicare and Medicaid Services (CMS) announced a final rule giving hospice a 3.8% Like other healthcare services reimbursed by Medicare, hospice has been subject to continuous pay cuts for roughly a decade.

NHPCO and HAN Call on Congress to Protect Hospice Medicare Benefits

NHPCO

NHPCO and HAN Call on Congress to Protect Hospice Medicare Benefits. This is a direct attack on access to the care that Medicare promises seriously ill beneficiaries. The post NHPCO and HAN Call on Congress to Protect Hospice Medicare Benefits appeared first on NHPCO.

Medicare’s Proposed 2023 Raise for Hospice is Only a Third of the Cost-of-Living Increase, Again

1-800-HOSPICE

With a 2% Medicare payment sequestration looming over hospice since 2013, news of a much needed raise comes with a sigh of relief. In a move that would repeat the 2021 suspension of hospice sequestration , Medicare recently proposed a 2.7% For 2023, Medicare’s recently proposed 2.7%

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All Hands on Deck! Federal Government Proposes Major Cuts to Home Health Funding

Hearts for Home Care

On June 17, the Centers for Medicare & Medicaid Services (CMS) proposed the largest cut to home health funding in Medicare’s 35+ year history.

COVID-19 Hospice How-To Series: Insights and Strategies for Virtual Visits, Telehealth and Medicare Appeals

Healthcare Law Insights podcast

We discuss the role of virtual visits, how to use telehealth, and the practical impact of the Medicare appeal waiver. We discuss the role of virtual visits, how to use telehealth, and the practical impact of the Medicare appeal waiver In today’s episode, your Hospice Team shares insights on operationalizing recent government guidance for hospices facing coronavirus obstacles.

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COVID-19 Hospice How-To Series: Recent Developments Regarding Telehealth, Virtual Visits, and Medicare Audits and Appeals

Healthcare Law Insights podcast

Your Hospice Team discusses these recent developments and their impact on telehealth, face-to-face encounters, virtual visits and Medicare appeals and audits. Your Hospice Team discusses these recent developments and their impact on telehealth, face-to-face encounters, virtual visits and Medicare appeals and audits Change is fast-paced in the world of COVID-19. On Monday, March 30th, CMS released an interim final rule along with hospice specific waivers.

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Inflation Reduction Act Imposes Prescription Drug Pricing Reforms

Healthcare Law Insights blog

The Act includes provisions targeting Medicare prescription drug costs, which could have wide-ranging effects for any party involved in the pharmaceutical industry, including drug developers, researchers, manufacturers, distributors, insurance companies, pharmacy associations and consumers.

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Hospice Audit Series: It’s That Time of Year Again: Quality Data Reporting Determinations Raise New and Recurring Issues

Healthcare Law Insights blog

Each July, the Medicare Administrative Contractors issue notices of a 2% Medicare payment reduction to those providers who did not meet quality data reporting requirements. Hospice & Palliative Care healthcare Medicare payment

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Healthcare Employers: CMS Deadlines for COVID-19 Healthcare Staff Vaccinations

Healthcare Law Insights blog

The Centers for Medicare and Medicaid (CMS), in an exercise of enforcement discretion, has begun monitoring covered CMS provider and supplier types for implementation of COVID-19 staff vaccination requirements in accordance with the COVID-19 Healthcare Staff Vaccination Interim Final Rule.

Telehealth Flexibilities Extended to Late 2022 and Likely Beyond

Healthcare Law Insights blog

In the Federal omnibus spending bill signed in March 2022, Congress extended current Medicare reimbursement waivers applicable to telehealth services for five months beyond the end of the PHE. Medicare will continue to cover certain audio-only telehealth services.

Employment Considerations for Long Term Care Facilities under the Biden-Harris Administration

Healthcare Law Insights blog

However, CMS has observed an overall increase in staffing levels since April 2018, when staffing measures were initially incorporated in the Nursing Home Compare Five-Star Quality Rating System and Medicare users began viewing how a nursing home’s staffing impacts their quality of service.

The Future of Hospital at Home

Healthcare Law Insights blog

Prior to the pandemic a Centers for Medicare and Medicaid pilot study yielded positive results with respect to hospital readmission rates and follow-up emergency department visits.

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MA Palliative Care Benefits See Little 2023 Growth, But Payer Interest Remains High

Hospice News

Only 10 new Medicare Advantage (MA) plans will offer home-based palliative care as a primarily health-related benefit for 2023, but payers may be offering those services through other programs. ” Through Medicare Advantage, the U.S.

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Hospice Market to Nearly Double by 2030; Palliative Care to See Large Gains

Hospice News

The Center for Medicare & Medicaid Innovation is currently testing coverage of hospice care through Medicare Advantage with the Value-Based Insurance Design (VBID) program. Often called the Medicare Advantage hospice carve-in, the program is reaching the close of its second year.

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Congress Takes Up Bill to Expand Advance Care Planning

Hospice News

and Susan Collins (R-Maine) have introduced a bill designed to foster greater access to advance care planning (ACP) among Medicare beneficiaries. Currently, physicians, other licensed independent practitioners, and clinical nurse specialists can conduct ACP conversations under Medicare rules.

Androscoggin CEO: Modernization of the Hospice Benefit is Coming With VBID

Hospice News

As the hospice community takes its first steps into value-based reimbursement, stakeholders have an opportunity to re-examine elements of the Medicare Hospice Benefit that may be outdated, according to some providers. The hospice benefit became a formal part of Medicare in 1983.

CMS Adds Health Equity Provisions to MA Carve-In; Participation Grows in 2023

Hospice News

Centers for Medicare & Medicaid Services (CMS) that health equity will be a key component of their payment model demonstrations going forward. The four-year program — often called the Medicare Advantage hospice carve-in — launched Jan.

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CMMI Working on Payment Models That Include Palliative Care

Hospice News

The Center for Medicare & Medicaid Innovation (CMMI) is developing new reimbursement pathways for palliative care. As part of that process, CMMI is applying elements of its Medicare Care Choices Model (MCCM) demonstration, which ended Dec.

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. The U.S.

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American Senior Communities Settles Hospice-Related FCA Case

Hospice News

Department of Justice alleged that the Indiana-based company billed Medicare separately for services that should have been covered by the hospice benefit. Medicare between 2010 and 2019 paid a total $6.6

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U.S. Senators Call on CMS to Boost Palliative Care Resources

Hospice News

Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure, calling for a payment model demonstration designed to support greater access to palliative care. A bipartisan group of nine U.S. Senators have written to U.S.

MedPAC: Streamline Alternative Payment Models

Hospice News

As hospices explore greater participation in alternative payment models, the Medicare Payment Advisory Commission (MedPAC) is urging Congress to reduce and restructure those programs. Hospice providers have been eying APMs emerging for the Center for Medicare & Medicaid Innovation (CMMI).

Four Organizations ask CMS for Increased Oversight to Curb Potential Fraud

NHPCO

For Immediate Release. November 21, 2022 .

Why SCAN Health Plan Will Enter Hospice VBID in 2023

Hospice News

SCAN Health Plan is among the Medicare Advantage (MA) payers entering the hospice component of the value-based insurance design (VBID) payment demonstration in 2023. The four-year program — often called the Medicare Advantage hospice carve-in — launched Jan.

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Hospice Regulations May Be Adversely Affecting Dementia Patients

Hospice News

These include the audit system created by Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, and the two-tiered reimbursement for routine home care that reduced payment amounts after 60 days.

4 Benefits of Hospice Contracts in ACO REACH

Hospice News

The Center for Medicare & Medicaid Innovation announced the program in February to replace the Global and Professional Direct Contracting (GPDC) models. We follow all the Medicare rules, but the arrangement itself may look different.