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Hospice Insider

Reimbursement:
New Nursing G Codes Finally Released For Hospice Reform
Track RN vs. LPN visits. If you want to avoid a major cash flow crunch in the New Year... Read more
Skilled Nursing Facilities:
Help Your SNF Partners Know Their New RAI Duties For Hospice Residents
Point out SCSA change in RAI Manual update. The Skilled Nursing Facilities your patien... Read more
Fraud & Abuse:
Fraud Trial Could Give Hospices Another Tool To Fight Whistleblower Suits
Jury finds claims false in first phase of trial. A trial that has caught the attention... Read more
Lawsuits:
Hospices Pay $12.6 Million In Recent Whistleblower Cases
Higher hospice care levels, aggressive marketing draw scrutiny. You can expect the num... Read more
Enforcement:
Authorities Crack Down On Hospice Fraud
Nurse imposter causes $2.3 million in false hospice claims. Whistleblowers aren’... Read more
Mergers & Acquisitions:
Hospices Combat Declining Reimbursement With Consolidation
‘Scale matters,’ says one market expert. Hospices are working hard to surv... Read more
Hospice News:
Time Hospice Cap Reporting To Your Advantage
Don’t wait too long to calculate your cap liability. Jan. 1 is looming large for... Read more
Hospice News:
Tell Referring Docs Advance Care Planning Rate Is Set
Physicians finally will have more financial incentive to discuss end-of-life choices, in... Read more
Hospice News:
Cost Report Changes For HHA-Based Hospices Posted
The Centers for Medicare & Medicaid Services has proposed changes to the home health... Read more
Hospice News:
Nursing Home-Hospice Partnership Highlights OIG's Blessing On Limiting Access
Baptist Retirement Community and Hospice of San Angelo in Texas are partnering, reports ... Read more
Hospice News:
2 Ohio Hospices Merge, But Keep Names For Now
Hospice of the Western Reserve and HMC Hospice of Medina County have merged. For the nex... Read more
Reader Question:
You Won't Get Off The NOE Timely Filing Hook For Your Own Billing Delays
Hospice argues it is processing time, not its own billing, that’s to blame. Ques... Read more
Reimbursement:
Concurrent Care Demo Rolls Exceeds Size Expectations
First phase begins Jan. 1. Hospices hope a new pilot project could broaden the hospice... Read more
Reimbursement:
Hospices Question Whether Concurrent Care Demo Pays Enough
Plus: Did CMS drag its feet on the concurrent care pilot? A larger-than-expected respo... Read more
Finance:
HHA-Based Hospices Should Prepare For Revamped Cost Reports
Make your accounting changes immediately. If you’ve been paying attention to cos... Read more
Hospice Item Set:
Double-Check Your Hospice Item Set Submissions
Use free resources to increase your HIS compliance. If you leave an important step off... Read more
Education:
Get Training On CAHPS, Payment Reform, ICD-10
Also, check out Eli audio conferences on hospice basics. You can receive vital informa... Read more
Billing:
Know The HETS Rules To Improve Your Hospice Payment Accuracy
The devil is in the details when it comes to entering beneficiary data. Starting in Ja... Read more
Notices Of Election:
Get Your Notice Of Election Facts Straight Before It Costs You
Tip: Don’t let coding changes delay your NOEs. Every day you’re late filin... Read more
Hospice News:
Hospice Star Rating System On Its Way
CMS may post deadline outside of rulemaking, it says. Medicare continues to move forwa... Read more
Diagnosis Coding:
You Must List All Of Patients' Diagnoses On Claims Starting Next Month
New requirement includes unrelated diagnoses, final rule stresses. Hospices are warily... Read more
Regulations:
Succeed Under Hospice 2016 Rule With These 5 Pointers
It’s time to kick your diagnosis coding documentation up a notch. Your payment w... Read more
Reimbursement:
Learn The Ropes For Hospice Payment Reform Billing
Catch: New nursing G codes won’t be out for a while. If you’re entering th... Read more
Billing:
Cut Troublesome Medications From Your Claims -- For Now
Will hospices’ drug costs go underreported? Hospices’ drug costs may go un... Read more
Cost Reports:
Cost Report Changes Afoot For Variety Of Hospice Types
Revisions follow in freestanding report’s footsteps. The Centers for Medicare &a... Read more
Hospice News:
High-Profile Trial In Hospice Whistleblower Suit Begins
One hospice chain’s sky-high live discharge rate is getting tested in court. A w... Read more
Hospice News:
National Chain Makes Big Hospice Buy
LHC Group Inc. has agreed to buy Halcyon Hospice LLC for about $58.5 million in cash, th... Read more
Hospice News:
2 Nonprofits In Florida Affiliate
The 31-year-old VNA and Hospice of the Florida Keys in Key West is forming an affiliatio... Read more
Hospice News:
Louisiana Hospice Acquires 2 Locations
EPI Group and Lafayette, La.-based Heart of Hospice have acquired for undisclosed terms ... Read more
Hospice News:
Hospice Closes Facility In Land Of Lincoln
Reimbursement constraints continue to take their toll on hospices. Hospice of Southern I... Read more
Reader Question:
Don't Let ICD-10 Delay Your NOEs -- And Cut Into Your Reimbursement
Switch to the new coding system is imminent. With the switch to ICD-10 almost upon you... Read more
Reimbursement:
New Hospice Payment Reform Model Hits Jan. 1
Hospices will see 1.1% pay increase overall. In the New Year, figuring out how many da... Read more
Payment:
CMS Relents So SIA Will Apply To Nursing Home Residents Too
Prepare to change how you bill nursing visits. Your nursing home patients won’t ... Read more
Reimbursement:
Above-Cap Hospices Fare Worst Under New System
Whether your Medicare reimbursement goes up or down under the new rule depends on your p... Read more
Finance:
Hospice Providers Will Be Happy To Say Good-Bye To BNAF Cuts
Plus: Prepare for CBSA transition. Seven years of Budget Neutrality Adjustment Factor ... Read more
Regulations:
More Hospices Likely To Exceed Caps Under New Rule
Change to slice half a billion dollars from reimbursement. The Centers for Medicare &a... Read more
Diagnosis Coding:
Get Ready To Shoulder A Drastically Expanded Diagnosis Coding Burden
Hospices have to take on increased coding and ICD-10 almost simultaneously. New diagno... Read more
Hospice Item Set:
New 30-Day HIS Submission Deadline Starts In January
You’ll lose out on payment if you don’t meet the threshold. Nearly a quart... Read more
Hospice News:
Beware New Hospice Denial Codes Indicating NOE-Delaying ICD-9, ICD-10 Problems
Get to know three new reason codes that will point the way to diagnosis coding troubles ... Read more
Reimbursement:
Beware Returned Claims When Meeting NOE Filing Deadline
Get answers to your burning NOE filing questions from one MAC. One MAC is offering a h... Read more
Referrals:
Physician Advance Care Planning Payment Could Boost Hospice
Medicare signals it’s ready to support advance care planning. Medicare appears r... Read more
Fraud & Abuse:
Lack of GIP Documentation Leads To $10 Million Settlement
Hospice agrees to 8-figure repayment after self-reporting. You’d better make sur... Read more
Compliance:
Publicly Traded Chain Under The Microscope -- Again
DOJ probes Amedisys, this time over hospice. The feds are combining two of their favor... Read more
Finance:
Hospices Open Inpatient Facilities Nationwide
From 3 to 16 beds, new facilities are serving their communities. GIP care may be on en... Read more
Appeals:
Prepare For Medicare Appeals Process To Change Drastically
Early stage appeals need to be more accurate, industry reps urge. Nearly everyone agre... Read more
Know Your Facts:
Appeals Timeframes Continue To Lengthen
Expect typical processing time for appeals decisions to exceed 540 days. Due to the ov... Read more
Mergers & Acquisitions:
Hospices Seek Affiliations In Increasingly Crowded Marketplace
Hospital closes hospice doors. Unreliable reimbursement and ever-increasing regulatory... Read more
Hospice News:
Hospices Finally Get A Break When It Comes to NOEs And Docs; NPIs
Doc number no longer a strict requirement, according to transmittal. For hospices that... Read more
Hospice News:
Examine These New Changes To The HIS Manual
If you missed CMS’s June 17 National Provider Call covering the updated Hospice It... Read more
Hospice News:
Tap Educational Resources For Pedes
If you’re looking for education materials relating to pediatric palliative care, t... Read more
Hospice News:
IACS Transition Drama Wraps Up
The troubled IACS-to-EIDM system transition is complete, CMS says. “CMS transition... Read more
Reimbursement:
Medicare Claims System May Lighten Your Load For Service Intensity Add-On Billing
Plus: Quality reporting penalties clarified in Open Door Forum. Hospices had many ques... Read more
Strategy:
Waste No Time In Initiating Payment Reform Prep
Run the numbers to see how proposed rule will impact your bottom line. Your reimbursem... Read more
Studies & Surveys:
Hospice Costs Medicare More When Patients Reside In Nursing Homes
Hospice reduces hospital admissions and aggressive care, though. Hospice services furn... Read more
Studies & Surveys:
Hospice Patients' Diabetes Care Too Aggressive, According To New Study
Physicians should discuss scaling back or discontinuing diabetes meds, study recommends.... Read more
Compliance:
Protect Yourself From These 5 Common Compliance Myths
Check out these misconceptions and why you shouldn’t keep believing them. You co... Read more
Compliance:
Don't Let Yourself Fall Victim To A Whisleblower Lawsuit
Employees often blindside owners, managers. A top compliance myth that has taken down ... Read more
Hospice News:
Tune In For New Hospice Item Set Training From CMS
Get vital details on the new HIS Manual. Hospices should mark their calendars for Hosp... Read more
Hospice News:
Are You Using Prior Authorization Form For Drugs?
The Centers for Medicare & Medicaid Services really wants you to use the P... Read more
Hospice News:
MAC Adds New Hospice Topic To Its Medical Review Hit List
Hospices aren’t just taking a beating in the popular press for high rates of live ... Read more
Hospice News:
Hospice Services Help Surviving Spouses Long After Care Ends, Study Shows
The Medicare hospice benefit may be under fire, but there’s no doubt it helps pati... Read more
Hospice News:
Review Your Discharge Ins and Outs
Brush up on your discharge responsibilities with a new booklet from the Centers for... Read more
Hospice News:
Health System Sheds Unprofitable Home Care, Hospice Agencies
Ambercare has acquired Gila Regional Medical Center’s Home Health a... Read more
Hospice News:
Say Goodbye To Extensions For ADRs
When you get a documentation request from your MAC or another Medicare entity (such as a... Read more
Hospice News:
Chicago Hospices Merge In Squeezed Market
Chicago-based Horizon Hospice & Palliative Care, Barrington, Ill.-based&nb... Read more
Reader Question:
Know When To File A Hospice Redetermination - And When Not To
Warning: Correcting the omission of the GW and GV modifiers may not be as easy as you th... Read more
Payment:
Medicare Unveils Hospice Payment Reform Plan
Get ready for a 2-tier reimbursement model. Hospices with long-stay and nursing home p... Read more
Reimbursement:
Payment Reform Proposal Takes Hospices By Surprise
More complex methodologies discarded. If Medicare’s hospice payment reform isn&r... Read more
Regulations:
Further Hospice Payment Changes Loom On Horizon
Your claims and cost report data could determine the next phase of reform. If you were... Read more
Payment:
Watch Out For Wage Index Changes In 2016 And Beyond
Plus: Cap changes are in the works. With major payment reform taking center stage in t... Read more
Hospice Item Set:
Prepare For 30-Day HIS Deadline Next year
Submitting Hospice Item Set data within a month no longer just a guideline. If you can... Read more
Quality:
CMS Plans To Place Star Ratings On Hospices
Your HIS, CAHPS data will soon be on display The date may be unclear, but you can bet ... Read more
Diagnosis Coding:
Hospices Must Place Unrelated Diagnoses On Claims, New Rule Proposes
CMS accuses industry of gaming the system. Medicare’s proposed instructions for ... Read more
Hospice News:
Look Over Your Cap Statements Carefully For Sequester Impact
Demand letter doesn’t spell out details. Now that Medicare Administrative Contra... Read more
Keep Your Eye On These Hospice Hot Spots
Half of hospice spending goes to long-stay patients, stats show. MedPAC thinks hospice... Read more
Know Your Facts:
LOS Is Down, But MedPAC Still Wants A Hospice Pay Freeze
Neuro conditions lead the pack for long stays. When you struggle day in and day out to... Read more
Payment:
MedPAC Turns Jaundiced Eye On For-Profits
Advisory body highlights LOS disparities. For-profit hospices have taken a beating fro... Read more
Benchmarking:
Watch For New SNF And ALF Data Targets In Your PEPPER Report
Access your benchmarking data — before regulators do. You should have an idea of... Read more
Business:
Hospices Continue Nationwide Trend Of Opening Inpatient Facilities
Will more inpatient availability help with feds’ concerns about GIP utilization? ... Read more
Hospice News:
Learn Notice Of Election Exception Lessons From One MAC's Examples
Tip: Pointing the finger at someone else won’t get you anywhere. Not sure how to... Read more
Hospice News:
Hospices Launch Class Action Lawsuit Against Cap Calculations With Sequester
A group lawsuit is now underway against cap calculations for 2013. After much confusion,... Read more
Hospice News:
Avoid, Clean Up 34923 Errors With This MAC's Advice
If your hospice claims are getting torpedoed by occurrence claim span (OCS) errors, Medi... Read more
Hospice News:
Don't Miss Hospice CAHPS May 1 Deadline
Take care to meet the May 1 deadline to turn in your hospice CAHPS survey vendor authori... Read more
Hospice News:
Learn These Hospice Payment Reduction Details
If you’re wondering exactly how the process will work when CMS docks your pay for ... Read more
Hospice News:
Watch Out For Retroactive Changes To Hospital-Based Hospice Cost Reports
Hospital-based hospices may have a tough time complying with CMS’s proposed deadli... Read more
Hospice News:
Court Shoots Down Suit On Hospice Religious Concerns
A federal court has dismissed an EEOC lawsuit against Fremont Regional Hospice in Canon ... Read more
Reimbursement:
Submit Your Hospice Cap Amount By March 31
CMS will include sequestration in the hospice cap calculation — but not right away... Read more
Strategy:
Use These 8 Pointers To Make Your Hospice Cap Deadline
Class action lawsuit waits in the wings. You’ve got a few short weeks to comply ... Read more
Finance:
Use These MAC Tools To Avoid Hospice Cap-Related Penalties
Follow your MAC’s instructions to submit hospice cap by March 31. How exactly se... Read more
Fraud & Abuse:
Whistleblower Lawsuits Cost Hospices Big Bucks
Feds focus enforcement resources on hospice industry. Hospices’ efforts to stay ... Read more
Education:
Get Training On Hospice Diagnosis Coding, Live Discharges
Also, check out Eli audio conferences on quality of care regulation, eligibility. You ... Read more
Hospice News:
Know The Ropes To Avoid Facility NPI-Related Denials
Report a facility NPI for these 5 place of service codes. If Reason Code 34952 errors ... Read more
Hospice News:
Proportion Of Hospice Chains Providing Medicare Services Shoots Up Over Last Decade
If you need proof that the hospice industry is changing rapidly, look to a study publish... Read more
Hospice News:
Submit HIS Data Or Face 2017 Pay Reductions
The Hospice Item Set data you’re submitting now will affect your 2017 payment rate... Read more
Payment:
Hospice Data May Result In Surprising Payment Reform Model
The final structure may not be what you expect. Skilled visits in the last days of dea... Read more
Fraud & Abuse:
OIG Puts Assisted Living Residents Receiving Hospice In Its Crosshairs
Hospice Compare is nearly on deck. If CMS heeds the OIG’s advice, you’ll b... Read more
Know Your Facts:
Skilled Visit Averages In Last 2 Days Vary Heavily Based On Day Of Week Death Occurs
Live discharges grow from 13% to 18% over decade. The Centers for Medicare & Medic... Read more
Reimbursement:
Hospice Payment Reform May Increase Methodology -- And Complexity -- Significantly
Certain routine days would pay more than $500 in one payment system iteration. Exactly... Read more
Regulations:
Sequestration Questions Dog Hospice Cap Calculations
Hospices wondering whether to include sequestration funds in their aggregate cap calcula... Read more
Billing:
Hospices Win One Concession On Notice Of Election Submission
Resubmit incorrect NOEs immediately, when errors fall into ‘billing’ categor... Read more
HIPAA:
Watch Out For These HIPAA Trends In 2015
Prediction: State law claims will continue to facilitate breach lawsuits. What does 20... Read more
Hospice News:
Check Out Latest Version Of Hospice Drug Prior Authorization Form
CMS hints at making the form mandatory. You can now take a look at CMS’s latest ... Read more
Hospice News:
Hospital-Based Hospices Get Their Turn
If it’s not love at first sight with the revised cost report for hospital-based ho... Read more
Reimbursement:
Get Ready To Make 2-Month Cap Window Or Face Payment Freeze
Line up your IACS access as soon as possible. Don’t forget you have a whole new ... Read more
Compliance:
Avoid These 6 Cap Reporting Pitfalls
Tip: Expect cap adjustment down the road. The learning curve on the new requirement to... Read more
Billing:
These 4 Notice Of Election Filing Exemptions May Save Your Bacon
Hint: Pointing the finger at staffing problems isn’t going to cut it. Is your ho... Read more
Studies & Surveys:
Nursing Homes And Hospices May Mix Better Than Authorities Think, Study Says
‘Crossover’ patients see longest stays, highest costs. Nursing home reside... Read more
Audits:
Say Hello To Your New Hospice Recovery Audit Contractor
RACs must meet new overturn cap. If you get hit by Recovery Audit Contractor review, i... Read more
HIPAA:
Hospice Paper Record Breach Plagues National Chain
Highway record dump makes the news. HIPAA penalties aren’t the only possible dam... Read more
Hospice News:
Get Ready To Defend Your Claims For 2 Nutrition-Related Groups
Focus on 6-month prognosis, MAC urges. Be sure your claims for hospice patients with t... Read more
Hospice News:
Keep Sequencing Up To Date For NOTR Submission Success
You’ll have a hard time making your Notice of Termination/Revocation filing deadli... Read more
Hospice News:
OIG Highlights Hospice Fraud Cases In Semiannual Report
Beware your financial relationships with your medical directors, suggests the latest HHS... Read more
Hospice News:
News Outlets Continue Criticism Of Hospice
Hospices continue to take a beating in the national press. Two new articles from The Was... Read more
Hospice News:
You Can Now Download CAHPS Exemption Form For Small Hospice Providers
Are you small enough to get out of new CAHPS requirements for hospice? If so, you’... Read more
Hospice News:
Multi-State Chain Adds West Coast Hospice Location
The Ensign Group has expanded its presence in Southern California. The Mission Viejo, Ca... Read more
Hospice News:
2 Non-Profit Hospices Join Forces In Buckeye State
Two Ohio non-profit hospices are teaming up. Hospice of Dayton and Cleveland-based Hospi... Read more
Hospice News:
Hospice Competition Heats Up In Florida
Numerous health care organizations are jumping at an opportunity to establish a hospice ... Read more
Reimbursement:
Beware Cap Calculations Set To Include Sequestration Dollars Medicare Never Paid You
Overpayments will be based on reimbursement you never received, CMS confirms. Hospices... Read more
Hospice Item Set:
Hundreds Of Hospices Lag On HIS Submission
NOE billing, CAHPS also addressed in Open Door Forum. You’d better get on the st... Read more
Billing:
How It Works: Notice Of Election Billing
For a reminder on how you can qualify for an exception to the five-day Notice of Electio... Read more
Studies & Surveys:
Another Study Proves Hospice Saves Money
75 percent of non-hospice patients died in facilities vs. 14 percent of hospice patients... Read more
Lawsuits:
Hospice Employee Whistleblowers Rake In Millions
Feds keep the heat on hospice providers in recent weeks. A whistleblower in the case a... Read more
Fraud & Abuse:
Watch For New Ways To Yank Your Medicare Billing Privileges
Providers may live in fear of arbitrary decision-making by CMS. Take extra care with y... Read more
Compliance:
These 6 Factors May Make Or Break Your Billing Under New Anti-Fraud Rule
New providers will be at a disadvantage. Medicare will use these six factors to decide... Read more
Enrollment:
CMS Will Use New Criteria To Deny, Revoke Enrollment
Plus: Your prior Medicare debt history will count against you. In addition to the revo... Read more
Hospice News:
Master Tricky Drug Reporting On Hospice Claims With This MAC's Tips
Medication reporting errors mess up hospice claims processing. Starting back in April,... Read more
Hospice News:
OIG Keeps Pressure On Home Health, Hospice
Don’t expect the feds to ease up on hospices any time soon. In its latest “T... Read more
Hospice News:
Know What To Include In Your ADR Response
How much is too much, not enough or just right? One Medicare Administrative Contractor h... Read more
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