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Longer Hospice Stays Lead to Larger Medicare Cost Savings

Hospice News

All told, hospice care — regardless of length of stay — saves Medicare approximately $3.5 Centers for Medicare & Medicaid Services (CMS) and the U.S. The post Longer Hospice Stays Lead to Larger Medicare Cost Savings appeared first on Hospice News.

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

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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.

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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

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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?

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Medicare Home Health Cuts Could Have Ripple Effect on Hospice, Palliative Care

Hospice News

Margin pressures from the proposed cuts to Medicare home health rates could impact palliative care and hospice. Centers for Medicare & Medicaid Services (CMS) in June released its proposed home health reimbursement rule for 2023, which included a 4.2%

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New Research Shows Hospice Care Reduces Medicare Costs

NHPCO

For Immediate Release March 22, 2023 New Research Shows Hospice Care Reduces Medicare Costs Hospice Care Contributed to $3.5 billion in savings for Medicare in 2019, while providing multiple benefits to patients, families, and caregivers.

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OIG Estimates $42 Million in Improper Medicare Payments for Advance Care Planning

Hospice News

Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently reported the results of its audit of advance care planning (ACP) billing practices among Medicare-certified physicians and other health care providers.

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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.

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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?

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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.

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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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Why CMS Extended VBID, MA Hospice Carve-In

Hospice News

Centers for Medicare & Medicaid Services’ (CMS) decision to extend the value-based insurance design (VBID) model through 2030: patients’ social needs, health equity and improved care coordination. Centers for Medicare & Medicaid ServicesThree main factors drove the U.S.

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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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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

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Medicare Changes Retirees Need to Know About

Comforcare Home Care

Here are some Medicare changes you might want to know about. Medicare will be able to negotiate drug prices (starting in 2023). Out-of-pocket insulin costs will be capped at $35/month for Medicare. Out-of-pocket drug costs on Part D will be capped at $2000/year starting in.

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How Long Will Medicare Pay for Hospice?

1-800-HOSPICE

However, when your hospice provider has Medicare certification, Medicare will pay 100% of costs including clinician fees and related supplies, equipment, and drugs. But how long will Medicare pay for hospice? Does Medicare Pay for Hospice?

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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

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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

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Medicare Gives Consumers a New Hospice Rating System

1-800-HOSPICE

In August 2022, Medicare included a new overall quality measure for Hospice Care Compare: the Hospice Care Index. Medicare derives the data exclusively from billing records, avoiding the potential bias of self-reporting that occurs in other Medicare Care Compare rankings.

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SCAN CEO Jain: Don’t Glorify Fee-for-Service to Improve Medicare Advantage

Hospice News

When stakeholders consider ways to improve Medicare Advantage, they should take care not to romanticize fee-for-service Medicare in the process, SCAN Health Plan CEO Dr. Sachin Jain cautions. Medicare Advantage (MA) is a growing force in health care.

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MedPAC Calls for Hospice Payment Cap Wage Adjustment, 20% Cut

Hospice News

The Medicare Payment Advisory Commission (MedPAC) has once again recommended a 20% cut to the aggregate cap for hospice payments. Centers for Medicare and Medicaid Services (CMS) set the 2023 cap at $32,486.92, up from nearly $31,300 per patient for Fiscal Year 2022.

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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.

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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.

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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.

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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.

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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.

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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.

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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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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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Elder Care Lawyer: Why Is It Important to Have One?

Caregiver Support Services

Medicaid and Medicare When attempting to negotiate the complex world of dealing with Medicare and Medicaid , hiring an elder care attorney is crucial. Older Americans who reach a particular age automatically qualify for Medicare. Medicaid and Medicare are intricate systems.

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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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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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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.

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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.

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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.

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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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CMS Extends Hospice VBID Through 2030

Hospice News

Centers for Medicare & Medicaid Services (CMS) is extending the value-based insurance design demonstration for calendar years 2025 to 2030, including the hospice component. This entire Medicare Advantage. The U.S.

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MA Beneficiaries More Likely than Fee-for-Service Patients to Enter Hospice from Community Setting

Hospice News

Medicare Advantage (MA) beneficiaries are more likely to enroll in hospice from a community setting than patients in traditional fee-for-service programs. In 2011, for example, 50% of MA patients came to hospice from the community, compared to 39% of those in traditional Medicare.

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Navigating the VBID hospice benefit in 2023

HEALTHCARE first

The Centers for Medicare and Medicaid Services (CMS) first launched its value-based insurance design (VBID) model in 2021. The model tests Medicare Advantage health plan innovations designed to reduce Medicare spending and improve the quality and delivery of care for Medicare beneficiaries.

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CMS Issues Final Rule for MA Risk Adjustment Audits

Hospice News

Many hospice providers rely on Medicare Advantage (MA) reimbursement to support palliative care, PACE and social determinants programs, among others. By establishing our approach to RADV audits through this regulation, we are protecting access to Medicare both now and for future generations.

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