Eli's Hospice Insider
CMS Shirks Fraud-Fighting Duties, Providers Gripe
Medicare needs to do more to boot fraudsters out of the system, attendees of the National Association for Home Care & Hospice’s March on Washington conference told a top Centers for Medicare & Medicaid Services official.
CMS isn’t using its data resources to target hospices who are flouting the rules for financial gain, one attendee told CMS Deputy Administrator Sean Cavanaugh in an April 4 session.
CMS seems to not use information it gathers in the survey process to target potential bad actors, another attendee said in a separate session.
Medicare isn’t doing its part “to help the industry get rid of … the bad apples,” another attendee told Cavanaugh. For example, CMS has yet to instruct its contractors to put hospice providers with long lengths of stay under medical review as spelled out in the Affordable Care Act.
Program integrity activities are “important,” Cavanaugh assured listeners. But he urged the “good guys” in the industry to think more about the overall direction the hospice benefit should move in the future.
Eli's Hospice Insider
- Payment:
Prepare For More Departures From Traditional Medicare Reimbursement
CMS pushes alternative payment models. As Medicare talks about ramping up hospice participation in alternative [...] - Reimbursement:
Notice Of Election Filing Problems Plague Hospice Reimbursement
Hospices hope for electronic filing solution from CMS. Your NOE deadline headaches may ease a [...] - Budget:
Declining Hospice Profit Margin Shouldn't Stop Rate Freeze, MedPAC Urges
Non-cancer diagnoses catch MedPAC’s eye. Flat spending and a decrease in live discharges won’t be [...] - Billing:
Hospice Reform Gives Rise To More Billing Glitches
The timing of one fix will withhold some SIA payments until this summer. Medicare has [...] - Fraud & Abuse:
OIG Accuses Hospices Of Overbilling For GIP
Watch out: Hospice-specific RAC in the works. Expect increased scrutiny of General Inpatient care following [...] - Regulations:
Hospices' Reimbursement Rates On The Line For Data Reporting
Plus: Sequestration is not going anywhere. Your CAHPS and HIS reporting stats are about to [...] - Lawsuits:
AseraCare Lawsuit Dismissal Gives Hope For Fighting Whistleblower Cases
Different medical opinions not enough to carry False Claims case, judge says. Whistleblowers won’t be [...] - Hospice News:
Download Latest PEPPER Reports With New Benchmarks
Free training available from PEPPER contractor later this month. You can take a look at [...] - Hospice News:
OIG Targets Hospice Patients In ALFs, Nursing Homes
The HHS Office of Inspector General would like to see some reimbursement-lowering mechanisms put in [...] - Hospice News:
CMS Shirks Fraud-Fighting Duties, Providers Gripe
Medicare needs to do more to boot fraudsters out of the system, attendees of the [...]
