The Centers for Medicare and Medicaid Services issued final rules for the hospice payment rate, the Medicare inpatient psychiatric facility prospective payment system (IPF PPS), and related quality reporting programs for fiscal year (FY) 2026.
CMS will update the IPF PPS payment rate by 2.5%, based on the 2021 market basket increase...CMS Rules
The Centers for Medicare and Medicaid Services released the proposed rule for 2025 hospice reimbursement including a 2.6% raise in per diems and two new quality measures.
The 2.6% net increase would amount to a $705 million increase from FY 2024, including a 3% market basket update and a 0.4% cut for productivity. According to the...Arizona News
Hospices in Arizona and three other states are now facing a "period of enhanced oversight" from the Centers for Medicare and Medicaid Services (CMS) for new hospices, following reports of unethical or illegal business practices including "fraud, waste and abuse."
The agency will require a medical review of claims before a Medicare...National News
This week, the Centers for Medicare and Medicaid Services (CMS) is learning from prior models and plans to make adjustments within Medicare Advantage for dual eligibles and hospice care. In other MA news, Anthem and UnitedHealthcare were penalized for failing to meet the medical loss ratio (MLR) threshold of 85%.
CMS is moving forward...White Papers, E books, Reports and more
According to a new report from the Government Accountability Office (GAO), Medicare Advantage beneficiaries in their last year of life transition to fee-for-service coverage at least twice as often as those who are expected to live longer. Healthcare costs associated with those patients were an estimated $422 million higher in 2016 than...CMS Rules
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on Monday that will expand the home health value-based purchasing (HHVBP) model, which was originally developed by the Center for Medicare & Medicaid Innovation (CMMI) in 2016. The rule also includes updates to the Medicare Home Health Prospective Payment...National News
The Biden administration has spent the first five months in office reviewing value-based care reimbursement programs authorized by the Centers for Medicare & Medicaid Services (CMS). Skilled nursing facilities (SNFs) and hospice providers, both integral parts of the Medicare program, still await instruction or expansion of...National News
Due to the COVID-19 pandemic, hospices had to quickly confront and adapt to constraints on providers and patient access. These challenges, coupled with some corrective policies and new opportunities through Medicare payment models mean that things are starting to heat up in the changing industry.
Looking forward to what is still yet to...National News
Last week, Medicare Payment Advisory Commission (MedPAC) met to present its draft recommendations for 2022 payment rules. Their implication: hospitals, physicians, hospices, outpatient dialysis centers, and ambulatory surgery centers will be just fine financially less than two years after the onset of the pandemic.
According to...National News
A recent report from the Government Accountability Office (GAO) found that discharges from hospice care prior to the death of a patient is much higher among for-profit hospices than similar nonprofit institutions.
The report also found that for-profit hospice care providers were less likely to visit dying patients within three days of...
The U.S. Department of Health and Human Services Office of Inspector General (OIG) analyzed data from more than 4,500 hospices participating in Medicare and found 80 percent had a deficiency, 20 percent had one or more serious deficiencies, a third had complaints filed against them and more than 300 were poor performers. The most recent...
The Pennant Group, a separately traded company, but a wholly-owned subsidiary of Ensign, would pick up Ensign’s home health and hospice operations, most of its senior living operations, plus mobile diagnostic and clinical laboratory operations.
Once the deal is complete The Ensign Group, Inc., will limit itself to transitional and...
