Hospice

News & Analysis as of

Don't Be Left On The Sidelines: CMS Is Seeking Applications For A New Hospice Demonstration Program

Currently, Medicare patients that wish to receive palliative hospice care have a tough choice to make—forgo any curative treatment or incur all hospice care costs. This could change, however, with the recent launch of CMS's...more

CMS to Test New Models of Care for Hospice: Summary of the Medicare Care Choices Model

On March 18, 2014, CMS launched an initiative to “develop innovate payment systems to improve care options for beneficiaries by allowing greater beneficiary access to comfort and rehabilitative care in Medicare and Medicaid.”...more

OIG 2014 Work Plan – Hospice

This article represents another installment of a series of articles that will outline the OIG’s activities, as discussed in the 2014 work plan, for a specific industry sector – hospice. For 2014, the OIG’s activities...more

White Collar Watch - February 2014

Contents - False Claims Act ruling opens door to large damage awards... pages 1 - 2 - Supreme Court asked if state universities are exempt from liability under the False Claims Act... pages 2 - 4 -...more

Alabama SHCC Update - February 2014

In this Update: - I. Public Hearings for Rules - A. 410-2-2-.08 Influenza - B. 410-2-3-.01 Hospice Services - II. State Health Plan Adjustment Applications - A. Consideration of Chilton County...more

CMS Clarifies Broad Scope of Hospices' Payment Responsibility for Part D Drugs

In a December 6, 2013 memorandum [PDF] to all Medicare hospice providers and Part D plan sponsors, CMS expressed concern that drugs covered under the Part A hospice benefit are being billed to Part D inappropriately....more

No, You Can’t Impose An Unknown Regulation On A Hospice Provider And Attempt To Retroactively Deny Payment

In December, 2013, the Pennsylvania Commonwealth Court ruled that a hospice facility’s due process rights were violated when the Department of Public Welfare (“DPW”) imposed an additional requirement without giving notice to...more

Medicare to Deny Certain Hospital Inpatient Claims for Hospice Patients

Under new CMS guidance, hospitals may have certain claims denied for inpatient services to a hospice patient. On November 7, 2013, CMS issued Change Request 8273 announcing changes in Medicare’s claims processing systems that...more

CMS Issues Warning on Medicare Part D Billing for Hospice Patients

Hospices will be expected to be more vigilant in their decisions to cover and pay for prescription medications covered under their Medicare hospice per diem payment. On December 6, the Centers for Medicare & Medicaid...more

Adult Failure to Thrive and Debility Can No Longer Be Principal Diagnoses on Hospice Claim Forms

Hospices will have until October 1, 2014, to ensure they conform their coding practices to comply with a “clarification” issued by the Centers for Medicare and Medicaid Services (CMS) in its final FY2014 Hospice Wage Index...more

Tennessee CON Report - September 2013

In This Issue: - 1. September 2013—Tennessee Certificate of Need Meeting - A. General Counsel’s Report - A. Certificate of Need Review: Community Hospices of America-Tennessee - A. Certificate of...more

CMS Issues Final Rule Regarding Required Agreements Between Long Term Care Facilities and Hospices

Beginning August 26, 2013, skilled nursing facilities participating in Medicare and nursing facilities participating in Medicaid (collectively referred to as “long-term care facilities”) that choose to arrange for the...more

New Requirement for LTC Facilities That Arrange Hospice Services through a Medicare-Certified Hospice

Effective August 26, 2013, the Centers for Medicare & Medicaid Services require that a long-term care, or LTC, facility that chooses to arrange for the provision of hospice services through a Medicare-certified hospice must...more

CMS Rule Complicates Long-Term Care Facility and Hospice Relationships

Final rule aims to improve the quality and consistency of care between long-term care facilities and hospice providers but may increase conflict between facility and provider staff. ...more

Health Care E-Note - June 19,2013

In This Issue: - FTC Hospital Merger Investigation Highlights Cost of Health Care - Survey Finds Doctors Warming to Health Information Exchanges - Health Insurance Markets Seeing More Competition from New...more

OIG Recommends that CMS Establish a Hospital Transfer Payment Policy for Early Discharges to Hospice Care

The OIG recently issued a report (A-01-12-00507) concerning the potential financial impact to Medicare Part A if CMS established a hospital transfer payment policy for early discharges to hospice care. The OIG explained that...more

Justice Department Lawsuit Reveals Roadmap to Avoid False Claims Act Liability

Earlier this month, the Justice Department filed a lawsuit against Vitas Hospice Services, LLC, and related entities, alleging that Vitas fraudulently billed the Medicare program in violation of the False Claims Act (FCA)....more

Health Reform + Related Health Policy News - May 2013

In This Issue: - Top News ..HHS Releases Hospital Pricing Data in Transparency Effort; Results Show Significant Variation ..States Divided on Medicaid Expansion ..CMS Issues FY 2014 Proposed Rules for...more

HHS OIG Issues Report on Hospice General Inpatient Care Billing

Report makes no formal recommendations, but OIG notes that lengths of stay and frequency of general inpatient care are issues requiring further scrutiny....more

CMS Issues Proposed Hospice Payment Update for FY 2014

On April 29, 2013, CMS issued a proposed rule providing the payment rates and wage index for hospices effective FY 2014. While the proposed rule describes current findings and offers options for consideration, it does not...more

MedPAC Issues FY 2014 Payment Recommendations for Inpatient and Outpatient Hospitals, LTCHs, Hospices and ASCs

The Medicare Payment Advisory Commission (MedPAC), an independent Congressional agency established to advise Congress on issues affecting the Medicare program, recently voted on FY 2014 payment recommendations for: (1)...more

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