Hospice

News & Analysis as of

OIG FY 2017 Work Plan Released: New Areas of Focus for Skilled Nursing Facilities, Hospices, and Home Health Agencies

In early November, the Office of Inspector General (OIG) released its 2017 Fiscal Year Work Plan, which summarizes new and ongoing reviews and activities that OIG plans to pursue with respect to Health and Human Services...more

OIG Releases 2017 Work Plan

On November 10, 2016, the Office of Inspector General (“the OIG”) of the U.S. Department of Health and Human Services (“DHHS”) is charged with ensuring the integrity of more than 100 programs administered by DHHS, including...more

Massachusetts Licensure of Hospice Programs Proposed Regulations – Key Take-Aways

Last week, the Massachusetts Department of Public Health issued another round of proposed amendments to its regulations, continuing the Baker Administration’s regulatory reform efforts. Today, we take a closer look at the...more

Massachusetts Regulatory Overhaul Continues

At Public Health Council meeting on November 9, 2016, the Massachusetts Department of Public Health (DPH) released yet another round of proposed regulatory amendments. On deck were regulations concerning Long Term Care...more

CA Nears Adoption of New Workplace Violence Regulations for Health Care Employers, Home Health Providers, and Emergency Responders

Seyfarth Synopsis: The California Division of Occupational Safety & Health Standards Board approved last week its regulations on Workplace Violence Prevention in Health Care. The California Division of Occupational...more

OIG Examines Compliance with Hospice Election Statement, Terminal Illness Certification Requirements

A recent OIG report examined whether hospices are meeting all requirements associated with the election statement that Medicare beneficiaries sign when they choose hospice care, and whether physicians are meeting all...more

CMS Delays Stricter Reviews of Medicare Home Care Claims

CMS recently announced a delay in the broad implementation of a stricter review program for Medicare home care claims that launched on a demonstration basis on August 3, 2016. CMS began the demonstration program to test...more

CMS to Scrutinize Hospice Election Statements, Physician Certifications

As a result of an Office of Inspector General (OIG) report released in September 2016, hospice providers can expect increased survey focus on the content of their hospice election forms and on physician certifications of...more

Florida Federal District Court Dismisses Plaintiff’s Qui Tam Action Against Hospice Providers

On September 22, 2016, the United States District Court for the Middle District of Florida granted defendant hospice providers’ motions to dismiss plaintiff-relator’s claims under the False Claims Act, Florida’s False Claims...more

[Event] Long-Term Care Conference - October 18th, Richmond, VA

Williams Mullen's Long-Term Care Conference will provide health care executives with the latest information on how to mitigate professional liability and regulatory risks; manage employment law matters, including overtime,...more

EndNotes - September 2016 - News for North Carolina's Hospice and Palliative Care Community

Nondiscrimination Final Rule under the ACA Imposes New Requirements on Hospice Agencies - On May 26, 2016, the United States Department of Health and Human Services (HHS), Office of Civil Rights (OCR), issued the...more

Nondiscrimination Final Rule under the ACA Imposes New Requirements on Hospice Agencies

On May 26, 2016, the United States Department of Health and Human Services (HHS), Office of Civil Rights (OCR), issued the “Nondiscrimination in Health Programs and Activities” final rule, implementing Section 1557 of the...more

Corporate Investigations and White Collar Defense - August 2016

Spotlight on the False Claims Act - Why it matters: This month, we review a recent Ninth Circuit case that allowed a qui tam relator’s action against various Medicare Advantage organizations to proceed, holding that the...more

CMS Releases Final Rule Addressing Hospice FY 2017 Wage Index, Payment Rates, and Quality Reporting

On August 5, 2016, CMS released a final rule addressing fiscal year (FY) 2017 updates to the hospice wage index, payment rates, and quality reporting requirements. Of note, the final rule increases hospice payments by 2.1...more

Alabama CON Report

I. Certificate of Need Program - A. AL2016-023, RehabCare Group East, Inc., Birmingham, AL: Proposes to relocate the existing multi-service outpatient rehab center from 100 Shadow Wood Park, Ste. B, Birmingham, Shelby...more

OIG Approves Hospice Payments to Nursing Facility for Dual Eligible Patients Under Medicaid Demonstration Project

On July 20, 2016, the Department of Health and Human Services, Office of Inspector General (OIG) issued a favorable Advisory Opinion (16-08) [PDF] regarding payments from a hospice to a nursing facility in which a dual...more

CMS Issues Final Update to Medicare Hospice Payment Rules for FY 2017

CMS has released a final rule that updates the Medicare hospice wage index, payment rates, and cap amount for fiscal year (FY) 2017. CMS estimates that the final rule will increase overall Medicare payments to hospices by...more

Payments to SNFs, Hospices and IRFs to Increase Under CMS Final Rules

On July 29, 2016, CMS released three separate final rules updating the fiscal year 2017 payment rates for skilled nursing facilities (SNFs), hospices and inpatient rehabilitation facilities (IRFs). Payments will increase...more

Health Care Market Intelligence: Post-Acute Care Summary Report - Q2 2016

Key Findings - - CMS proposed an $800-million Medicare payment increase for SNFs in FY 2017, a 2.1% increase from this year, while hospice payments would rise by $330 million, or 2%. Home healthcare agencies may see a...more

OIG Gives Green Light to Hospice Provider’s Payment to Nursing Facilities

Last week, the OIG issued a favorable opinion to a hospice provider seeking to make supplemental payments to skilled nursing facilities. Under the proposed arrangement, the hospice provider would make a supplemental payment...more

DOJ Announces Will Appeal Loss in AseraCare, Triggering Issues on Battle of the Experts, Statistical Sampling, and Bifurcation

$200 million and pivotal legal precedent are at stake in the False Claims Act (“FCA”) case against AseraCare, Inc. (“AseraCare”), a for-profit hospice chain that was alleged to have fraudulently submitted claims that falsely...more

Another Court Rejects Statistical Sampling and Rules That Difference of Opinion About Hospice Eligibility Is Insufficient for...

Back in March of this year, in U.S. ex rel. Paradies v. AseraCare, Inc., a district court in Alabama granted summary judgment to a defendant hospice finding that an expert physician’s disagreement with a certifying...more

Physical security still an issue: Pruitt Health suffers breach in break-in

The importance of physical security and the risk associated with the unauthorized access to or loss of paper records is clear from recent experiences of Pruitt Health in South Carolina. On March 2, 2016, an intruder...more

Hospice Requests Supreme Court Review of Medicare Hospice Annual Cap

On June 8, 2016, Southeast Arkansas Hospice, Inc. (SEARK) filed a petition for a writ of certiorari to the Supreme Court to review an Eighth Circuit decision that upheld the annual Medicare payment cap for hospice services. ...more

MedPAC Releases Comment Letters on Fiscal Year 2017 Inpatient Hospital, Hospice, Skilled Nursing, and Inpatient Rehabilitation...

In late May, the Medicare Payment Advisory Commission (MedPAC) issued comment letters in response to multiple CMS payment proposals in which MedPAC encouraged refinements to the hospital star rating system to emphasize...more

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