Advanced Search

Home Health & Hospice Week

Industry Notes:

Federal Court Decision Invalidates Hospice Caps

Published on Fri Feb 11, 2011

A recent federal court decision may bring hospices one step closer to the end of theMedicare hospice cap. A decision handed down Feb. 28 by the U.S. District Court for the Northern District of Oklahoma, declared the hospice cap regulation invalid. In fact, there have been numerous cases on this issue, and "every court that has considered the issue has held that 42 C.F.R. §418.309(b)(1) is invalid," notes U.S. District Judge Gregory Frizzell in the opinion in Infinity Care of Tulsa v. Sebelius (Case No. 09-CV-723-GKF-FHM). Background: In 2007, Infinity Care of Tulsa received about $5.2 million in Medicare payments, according to the decision. But Medicare demanded recoupment of about $1 million based on the per beneficiary cap.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Home Health & Hospice Week

View All