Hospice News

OCTOBER 28, 2024

Fraudsters misspend millions of Medicare dollars annually, though the actual hospice-specific amounts are difficult to determine, regulators previously told Hospice News. In the end, Medicare fraud costs taxpayers billions of dollars every year. Each dollar lost to fraud takes away resources intended for people with Medicare.”

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Hospice News

NOVEMBER 11, 2024

Centers for Medicare & Medicaid Services (CMS) recently announced that its Medicare Shared Savings Program (MSSP) yielded more than $2.1 As of January 2024, roughly 480 ACOs are participating in MSSP, which include more than 608,000 clinicians who provide care to nearly 11 million Medicare beneficiaries.

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Hospice News

APRIL 10, 2024

The Medicare Hospice Benefit could use an “upgrade” to ensure greater flexibility that may be necessary to fully support patients’ needs. Centers for Medicare & Medicaid Services (CMS) should consider is retiring the six-month terminal prognosis requirement and allowing for some concurrent care, Wallace and Wladkowski indicated.

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Hospice News

MAY 28, 2024

Centers for Medicare & Medicaid Services (CMS) in March issued its 2025 proposed hospice rule, which if finalized would include a 2.6% Most hospices also do not have a diversified payer mix and are dependent on the Medicare Hospice Benefit. “We The proposed 2.6% increase in the per diem base rate.

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Hospice News

DECEMBER 26, 2024

A Ventura County, California, physician has been sentenced to 24 months in federal prison for Medicare fraud for medically unnecessary hospice services. In total, approximately $3,917,946 in fraudulent claims were submitted to Medicare, of which a total of approximately $3,289,889 was paid. and Saint Mariam Hospice Inc.

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Hospice News

OCTOBER 31, 2024

Centers for Medicare & Medicaid Services (CMS) in response to fraud allegations that have resulted in licensure and billing privilege revocation. District Court for the Central Division of California to allow for continued Medicare licensure until the fraud dispute is resolved through the U.S. court documents stated.

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Rehab Realities by Renee Kinder

NOVEMBER 7, 2024

The Medicare Physician Fee Schedule (MPFS) is the system through which the Centers for Medicare & Medicaid Services determines payment rates for services provided by physicians and other healthcare professionals. This year’s Medicare Physician Fee Schedule rule was released last Friday (Nov.

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Hospice News

DECEMBER 20, 2024

Centers for Medicare & Medicaid Services (CMS) found. Total Medicare hospice spending accounted for $25.7 billion last year, according to a separate report from the Medicare Payment Advisory Commission (MedPAC). Total Medicare hospice spending accounted for $25.7 The nations total health expenditures rose 7.5%

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Hospice News

MAY 9, 2025

Petros Fichidzhyan, 44, of Granada Hills, California, has been sentenced to 12 years in prison and three years of supervised release for his role in a mulit-year scheme to defraud Medicare of more than $17 million. Medicare paid the sham hospices nearly $16 million, of which Fichidzhyan received nearly $7 million, with more than $5.3

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Hospice News

FEBRUARY 28, 2025

of Medicare hospice decedents terminal conditions in 2023, according to a recent joint report by the Alliance and the Research Institute for Home Care. With the] number of Medicare hospice users, we are seeing major increases over years, as you expect with an aging population, Ware said during a recent webinar.

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Hospice News

FEBRUARY 4, 2025

A guilty plea has been filed in a hospice fraud scheme that allegedly bilked Medicare for $17 million in false claims. As a result of the scheme, Medicare paid the sham hospices nearly $16 million, according to the Justice Department. Justice Department. He allegedly attempted to cover up by paying the physician $11,000.

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Hospice News

DECEMBER 27, 2024

Centers for Medicare & Medicaid Services value-based insurance design (VBID) model. Launched in 2017 by the Center for Medicare and Medicaid Innovation (CMMI), the VBID demonstration tested new approaches to reimbursement across a variety of health care settings.

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Hospice News

NOVEMBER 4, 2024

Centers for Medicare & Medicaid Services (CMS) has finalized a nearly 2.9% To put it bluntly, Medicare plans to pay us less while costs go up. Since 1992, Medicare payment has been made under the PFS for the services of physicians and other billing professionals. Industry organizations were quick to denounce the pay cut. “To

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Hospice News

FEBRUARY 14, 2025

Centers for Medicare & Medicaid Services (CMS), the National Institutes of Health, the U.S. He cited a goal to work with Medicare, Medicaid and Medicare Advantage programs in varied ways that improve health outcomes for beneficiaries. HHS subagencies include the U.S. Food & Drug Administration, among others.

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Hospice News

MARCH 17, 2025

Congress has passed the Full-Year Continuing Appropriations and Extensions Act 2025 (FY2025) , which allowed for continuation of several public health, Medicare and Medicaid authorities and programs. Centers for Medicare & Medicaid Services (CMS) temporarily instituted waivers during the public health emergency.

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Hospice News

MAY 16, 2025

The nonprofit Medicare Advantage and health care services organization SCAN Group has fully acquired the myPlace Health, in which it previously held a partial stake. SCAN Health Plan is among the nations largest Medicare Advantage organizations, covering more than 300,000 lives across California, Arizona, Nevada, Texas and New Mexico.

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Hospice News

FEBRUARY 10, 2025

He was so intrigued that he gathered a few volunteers and began Hospice of the Valley, which was largely a volunteer organization living off of a few grants here and there prior to when hospice Medicare reimbursement came around in the early 1980s. There was a lot of community involvement. That is the future.

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Hospice News

NOVEMBER 21, 2024

Centers for Medicare & Medicaid Services (CMS) could produce misinformation that could interfere with access to care. Hospices flagged by the SFP also will be surveyed every six months rather than the current three-year cycle and could face monetary penalties or expulsion from the Medicare program. The program, set to begin Jan.

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Hospice News

JANUARY 30, 2025

Centers for Medicare and Medicaid Services (CMS) regulatory oversight approach could potentially put some new hospices out of business, according to Bryan Nowicki, partner at the law firm Husch Blackwell. The risks include potential revocation of Medicare privileges and licensure and termination of the hospices provider number.

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Hospice News

NOVEMBER 14, 2024

Centers for Medicare & Medicaid Services (CMS) has issued a memo to accreditation bodies and state agencies advising surveyors to watch out for potential hospice fraud. The memo directs surveyors to refer issues to CMS if they suspect fraudulent activity.

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Hospice News

NOVEMBER 4, 2024

About 15,900 Medicare decedents in Utah elected hospice in 2022, a rate of slightly more than 59%. Centers for Medicare & Medicaid Services (CMS). The final rule forbids any change in majority ownership during the 36 months after initial Medicare enrollment, including acquisitions, stock transactions or mergers.

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Hospice News

FEBRUARY 28, 2025

Centers for Medicare & Medicaid Services (CMS) implemented telehealth recertifications on an emergency basis during the pandemic. Centers for Medicare & Medicaid Services (CMS) has given no indication that it would do so. Since then, expiration dates for that flexibility have been extended several times.

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Hospice News

DECEMBER 12, 2024

Centers for Medicare & Medicaid Services (CMS) has not responded to congressional concerns about the hospice Special Focus Program (SFP). Set for 2025 implementation, the SFP promises to identify hospices delivering poor quality care and target them for improvement remedies.

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Hospice News

MARCH 14, 2025

The Medicare Payment Advisory Commission (MedPAC) has recommended to Congress a freeze on hospice payment increases starting in 2026. The 2021 aggregated Medicare hospice margin was 10.4%, according to MedPAC. million Medicare beneficiaries received services in 2023 from close to 6,500 providers, up from 5,900 the prior year.

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Hospice News

APRIL 28, 2025

The report, Trends, Patterns, and Key Comparisons Related to New Medicare Hospice Provider Enrollments May Indicate the Need for Further Oversight is expected to publish in Fiscal Year (FY) 2026. It will examine potential red flags of fraud, waste and abuse among newly enrolled Medicare hospice providers claims data.

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Hospice News

DECEMBER 23, 2024

Centers for Medicare & Medicaid Services has made public its first cohort for the hospice Special Focus Program (SFP). The program would have the authority to impose fines, suspend reimbursement, appoint temporary management to bring the hospice into compliance or revoke a providers Medicare certification altogether.

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Hospice News

DECEMBER 5, 2024

Hospice providers can collaborate with institutional special needs Medicare Advantage plans (ISNP) to reach patients who reside in long-term care facilities. An ISNP is a Medicare Advantage plan for those living in a nursing home. The payment model aligns with the general Medicare Advantage rubric.

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Hospice News

MARCH 4, 2025

Bill is an icon in the industry and a staunch Medicare beneficiary advocate, always putting patients first and fighting for their rights and benefits. He was instrumental in the development of the Medicare Prospective Payment System (PPS), which emerged in home health reimbursement in 2000.

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Hospice News

JANUARY 8, 2025

Hospice utilization reached 43.77% among Medicare decedents in Hawaii during 2022, according to a report from the National Alliance for Care at Home. Several of the hospices in the collaborative launched services in early 1980s when the Medicare Hospice Benefit was established. This fell below the national average of 49.1%

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Hospice News

MARCH 4, 2025

The value-based agreement contracts Thyme Care with Humana Medicare Advantage plans, giving them access to their beneficiaries. Humana Medicare Advantage members who are eligible for the program in Michigan, New York, Illinois, Indiana, Tennessee, Pennsylvania and New Jersey may now receive services from Thyme Care.

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Hospice News

MARCH 5, 2025

Some of the requirements stipulated that operators must be accredited and be Medicare certified. Other proposed requirements would prohibit a hospice program from accepting new patients or transferring their billing Medicare billing privileges in certain circumstances.

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Hospice News

DECEMBER 3, 2024

About 48,644 Medicare decedents utilized hospice services that year, a lower number compared to other states, according to the U.S. Centers for Medicare & Medicaid Services (CMS). New York state had the fourth largest aging population nationwide in 2021, with 4.6

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Hospice News

APRIL 3, 2025

Complexities of hospice room-and-board RCM Hospices make room-and-board payments to nursing homes for terminally ill patients who are dually eligible for Medicare and Medicaid. It takes more administrative work to get the claims processed than a Medicare claim requires, because Florida turned Medicaid over to managed care companies.

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Hospice News

MARCH 19, 2025

After hiring their first nurse, Shayla Rowley, who is now COO, the team had plenty of knowledge about the home health and hospice aspects of Medicare Part A, which they used as the basis of their operational model. They quickly ramped up on Medicare Part B, physician care, and used it to create their service lines and billing codes.

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Hospice News

JANUARY 17, 2025

Earl Blumenauers (D-Oregon)] proposal for reform incorporated both payment for some types of palliative care, and aspects of [the Medicare Care Choices Model ] that allowed some care and support prior to hospice election. Its complicated because there are so many treatments and interventions that are considered palliative.

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Hospice News

FEBRUARY 12, 2025

Our philosophy is that palliative care as a whole should be kind of a blanket that goes over all of those things and helps coordinate the care that those patients need across all of those settings, no matter which specialists they’re seeing or which which Medicare defined service line they’re a part of, Walker told Palliative Care News.

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Hospice News

NOVEMBER 6, 2024

Hospices flagged by the SFP also will be surveyed every six months rather than the current three-year cycle and could face monetary penalties or expulsion from the Medicare program. The SFP has the authority to impose enforcement remedies against hospices with poor performance based on its algorithm.

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