Hospice

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Health Headlines: Also in the News - July 2014 #3

CMS Revises Medicare Advantage and Part D Prescription Drug Plan Prior Authorization Requirement for Hospices – On July 18, 2014, CMS released a revised a memorandum outlining responsibility for drug payments for hospice...more

Managing Regulatory Risk in Nursing Home-Hospice Arrangements

Challenges of Nursing Home-Hospice Arrangements. As a nursing home resident's life expectation sunsets, transfer of the resident from the restorative care of a skilled nursing facility (SNF) to the palliative care of a...more

Proposed Hospice Rule Focuses on Unbundling of Services

On May 8, CMS released a proposed rule in the Federal Register providing for a payment increase of 1.3 percent for fiscal year (FY) 2015. Among other provisions, CMS’s proposed rule offers hospice providers an update on...more

Alabama CON Report - May 2014

In this Report: - I. Certificate of Need Program - A. 2014-013, VITAS Healthcare Corporation - B. Contested Case - C. Contested Case - D. Contested Case - II. Reviewability...more

Health Headlines: Also in the News - May 2014

CMS Proposes Payment Changes for Hospice Providers, SNFs, IRFs and Inpatient Psych Facilities – Last week, CMS issued proposed rules that would make certain payment and policy changes to the payment systems for...more

CMS's New System of Records for the Hospice Quality Reporting Program

On April 8, 2014, CMS published in the Federal Register a “Notice of a New System of Records (SOR).” CMS is establishing a new SOR titled, “Hospice Item Set System” (or HIS). ...more

Tennessee CON Report - April 2014

In this Report: - I. April 2014 — Tennessee Certificate of Need Meeting - A. Certificate of Need Review - II. Certificate of Need Program Report — Filings Since March 2014 Meeting - B. Applications for...more

Health Law Insights Newsletter - April 2014

In This Issue: - Federal Updates - State Updates - HIPAA Updates - Excerpt from Centers for Medicare & Medicaid Services Issues Guidance for Meaningful Use Hardship Exception: The Centers...more

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

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