Hospice

News & Analysis as of

Tax Changes Made by Maine's 127th Legislature

The Maine Legislature ended its tumultuous session on July 16, 2015. After an advisory opinion by the Maine Supreme Court, we now know which bills actually became law. As usual, a number of significant tax issues were...more

Shifting Hospice Reimbursement – Moving in the Direction of Aligning Payment with Resource Concentration

The United States Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) published its update to the home health prospective payment system (HHPPS) for fiscal year (FY) 2016 in the August...more

Hospice Cap Demand Group Appeal Deadline

As you likely are aware, Medicare hospice payments were reduced by two percent in accordance with a sequestration order issued March 1, 2013, pursuant to Section 251A of the Balanced Budget and Emergency Deficit Control Act....more

Also In The News - Health Headlines - August 2015

CMS Issues SNF Final Payment Rule for FY 2016 – On July 30, 2015, CMS released the final Medicare FY 2016 payment rule for skilled nursing facilities (SNFs). The final rule will result in an estimated increase of $430 million...more

CMS Finalizes Medicare Hospice Wage Index/Rates for FY 2016

On August 6, 2015, CMS is publishing its final rule to update Medicare hospice payment rates and the wage index for fiscal year (FY) 2016. CMS estimates that the final rule will increase overall payments to hospices by about...more

Key Ruling In False Claims Act Case Could Have Important Implications For Defendants

A recent decision out of a United States District Court in Alabama may signal that the playing field traditionally dominated by the government will no longer be so one-sided against providers defending against False Claim Act...more

CMS Announces Hospices Invited to Participate in the Medicare Care Choices Model

On July 20, 2015, CMS announced the hospices invited to participate in the Medicare Care Choices Model. Under current Medicare rules, a Medicare beneficiary must forgo curative treatments to receive palliative care provided...more

Final FY 2016 Medicare Payment Rules on the Horizon

Despite the recent flurry of activity on Medicare payment rules, more are in the pipeline. CMS has sent the final fiscal year (FY) 2016 Medicare skilled nursing facility, hospice, inpatient rehabilitation facility, and...more

Time to Revisit Your Physician Relationships

On June 9, 2015, the Department of Health and Human Services, Office of Inspector General issued a new Fraud Alert entitled "Physician Compensation Arrangements May Result in Significant Liability" (Alert) in the wake of 12...more

Recent OIG Audits of Home Health and Hospice Surveys May Signal Increased Scrutiny on Worker Qualifications

Recent audits by the Department of Health and Human Services Office of Inspector General (“OIG”) conclude that state survey agencies in a number of states and a leading national accrediting agency serving the home health and...more

Washington Healthcare Update

This Week: House Ways & Means Committee Holds Markup; Makes Significant Legislative Changes to Health Care Bills... Senate Finance Committee Holds Markup on Medicare Appeals Process Bill... CMS Issues Final Rule on...more

Washington Healthcare Update

This Week: House E&C 21st Century Cures Bill Passes Unanimously Out of Committee... House Votes to Codify Permanent R&D Tax Credit... CMS Released Proposed Rule Concerning Medicaid and CHIP Plans....more

CMS Proposes Updates to Medicare Hospice Wage Index/Rates for FY 2016

CMS published a proposed rule on May 5, 2015 that would update Medicare hospice payment rates and the wage index for fiscal year (FY) 2016. CMS estimates that the proposed rule would increase overall payments to hospices by...more

CMS Call on Hospice Quality Reporting (June 17)

CMS is hosting a June 17, 2015 provider call to discuss the Hospice Quality Reporting Program and the new Hospice Item Set (HIS) Manual (V1.02). The target audience includes quality staff at Medicare-certified hospice...more

CMS Proposes Payment Reform/Cap Adjustments

On April 30, 2015, CMS released its FY 2015 Hospice Wage Index, including long anticipated payment reform and some changes to the hospice cap calculation. Comments are due by June 29. Here is an initial summary and...more

CMS Issues Proposed Rule Raising Hospice Provider Payments in FY 2016

On April 30, 2015, CMS issued a proposed rule that would give hospices serving Medicare beneficiaries an estimated 1.3 percent ($200 million) increase in their FY 2016 payments. Comments on the proposed rule are due by June...more

Washington Healthcare Update

This Week: House E&C Releases Discussion Draft of 21st Century Cures Legislation Ahead of Legislative Hearing... FDA Finalizes Biosimilar Guidance Documents... CMS Updates Wage Index and Payment Rates for the Medicare Hospice...more

False Claims Act – 2014 Year in Review

The False Claims Act (FCA) imposes liability on individuals and companies who defraud or submit false claims to the federal government. The FCA allows the federal government to seek treble damages, civil penalties and...more

Hospice Provider Pays $4 Million to Settle Allegations of Fraudulent Billing

Good Shepherd Hospice, Inc., a for-profit hospice providing services in Oklahoma, Missouri, Kansas, and Texas (“Good Shepherd”), has agreed to pay $4 million to the U.S. government to settle allegations that it submitted...more

OIG Report Outlines Five Recommendations for Hospice Care Reform

The Patient Protection and Affordable Care Act requires the Centers for Medicare and Medicaid Services (“CMS”) to reform the hospice payment system, collect data relevant to revising hospice payments and develop quality...more

Gear Up for Increased CMS Scrutiny of Hospice Services for Assisted Living Facility Residents - EndNotes February 2015

A recent study issued by the evaluation and policy division of the U.S. DHHS Office of Inspector General (OIG) indicates that hospices can expect increased scrutiny regarding the services they provide to assisted living...more

Happy New Year from the DC District Court - Companionship Exemption Lives On!! - EndNotes February 2015

Home care patients, caregivers and the entire home care community celebrated a huge victory to kick off 2015. The U.S. District Court for the District of Columbia (DC court) vacated the U.S. Department of Labor’s (DOL’s)...more

End Notes Newsletter February 2015 - News for North Carolina’s Hospice and Palliative Care Community

In this issue: - Gear Up for Increased CMS Scrutiny of Hospice Services for Assisted Living Facility Residents - Happy New Year from the DC District Court - Companionship Exemption Lives On!! - DEA Rules On...more

OIG Report Recommends Reforms to Reduce Hospice Incentives to Provide Care in Assisted Living Facilities

On January 14, 2015, OIG published a report that analyzes Medicare payments for hospice care in assisted living facilities (ALFs). OIG concluded that CMS should implement measures to reform Medicare payments to hospices,...more

OIG Questions Incentives for Hospice Care in Assisted Living Facilities

Today the OIG issued a report examining the growing use of Medicare hospice care in the assisted living facility (ALF) setting. According to the OIG, Medicare payments for hospice care in ALFs grew by more than 119% from 2007...more

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