A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Counsel That Cares - The Private Payer's Perspective on Value-Based Care
Business Better Podcast Episode: 2024 Advance Notice: Proposed Changes to the Medicare Advantage Risk Adjustment Model
Video: Record-Shattering Year for FCA Recoveries in Health Care - Thought Leaders in Health Law
Hooper, Kearney and Macklin on Cutting Edge Topics in the False Claims Act
Hospice Audit Series: The Latest Developments and Strategies for Success in the Ever-changing Audit Landscape
Podcast: IP(DC): Drug Prices, Political Pressures & Patents
Introduction - Polsinelli proudly introduces the Health Care Fraud and Abuse 2023 Year in Review, a comprehensive examination of the evolving landscape surrounding the False Claims Act (“FCA”) and fraud & abuse enforcement...more
It came as a surprise to our team when we learned that the Centers for Medicare & Medicaid Services (CMS) was ending the hospice component of Value-Based Insurance Design (VBID) on December 31, 2024. Upon learning this, Husch...more
A joint report published on March 22, 2023 found the total costs of care for Medicare beneficiaries who used hospice was 3.1 percent lower than those who did not, and that earlier enrollment in hospice and longer lengths of...more
The traditional world of Medicare-certified home health and hospice is changing rapidly. To the surprise of many, though the pandemic has been an accelerant, the reasons are more fundamental, and at the core are forces...more
At the annual Home Care 100 Conference this past week, I had the pleasure of moderating a panel of top executives in the home health, hospice, palliative, and integrated primary care business models discuss leading trends in...more
Hospice Audits Series Audits are a fact of life for hospices—it’s not a matter of “if” a hospice will be audited, but “when.” The alphabet soup of audits has expanded, from UPICs to SMRCs, CPIs, TPEs and more. With the...more
CMS Announces Hospice Capitation Rates for Medicare Advantage - The U.S. Centers for Medicare and Medicaid Services (CMS) recently released the capitation rates for hospice care through the value-based insurance design...more
The U.S. Centers for Medicare and Medicaid Services (CMS) recently released the capitation rates for hospice care through the value-based insurance design model (VBID), often referred to as the Medicare Advantage hospice...more
Over the past week, the Centers for Medicare & Medicaid Services (CMS) has issued a flurry of guidance documents and FAQs regarding COVID-19 for healthcare providers in private practice, hospitals, nursing homes, hospices and...more
Despite the pressure and turmoil going on in certain sectors of the health care continuum, both home health and hospice continue to shine as attractive investment and expansion opportunities for existing providers. Each...more
Discover the factors that drove healthcare M&A activity in 2019. Innovation, expansion and continued private equity investment in the industry influenced healthcare transactions last year. 2019 saw continued robust...more
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
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 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