Articles and Blogs

According to a statement released on the Center for Medicare and Medicaid Services (“CMS”) website, effective February 14, 2025, implementation of the Hospice Special Focus Program for calendar year 2025 has ceased so that CMS may further evaluate the program. Hospice Special Focus Facility Program (“SFP”) The Consolidated Appropriations Act of 2021 called for... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) is reinforcing its emphasis on hospice quality of care and identifying fraud. On November 13, 2024, CMS issued a QSO Memo, “Ensuring Consistency in the Hospice Survey Process to Identify Quality of Care Concerns and Potential Fraud Referrals” (the “CMS Memo”), addressing the importance of consistency in... READ MORE

Over the last 12 months, the Centers for Medicare & Medicaid Services (“CMS”) has received many reports of hospice fraud. In addition, CMS has seen the number of enrolled hospices increase significantly in Arizona, California, Nevada and Texas, raising concerns about market oversaturation.  On July 12, 2023, CMS released a Medicare Learning Network article (the “CMS Oversight Policy”)... READ MORE

The Consolidated Appropriations Act, 2021 (the “Act”) was signed into law on December 27, 2020 and recasts the Medicare hospice survey requirements and establishes new Medicare enforcement options and procedures. The Act’s hospice provisions generally track those contained in the Helping our Senior Population in Comfort Environments, also known as the HOSPICE Act, which... READ MORE

On March 13, 2020, Secretary Azar of the Department of Health and Human Services (the “HHS”) issued a letter titled “Waiver or Modification of Requirements Under Section 1135 of the Social Security Act” (the “Azar Letter”) that grants the Centers for Medicare & Medicaid Services (the “CMS”) the authority to issue waivers specific to... READ MORE

On December 11, 2019, the Center for Clinical Standards and Quality/Quality, Safety & Oversight Group at the Centers for Medicare & Medicaid Services (“CMS”) issued a memorandum to State Survey Agency Directors entitled “Fiscal Year (FY) 2020 Mission & Priority document (MPD) – Action” (“FY 2020 Memo”) that announced its work and intentions for the fiscal... READ MORE

On March 13, 2015, the Medicare Payment Advisory Commission (“MedPAC”) released its annual report to Congress (“Report”). The Report contains MedPAC’s recommendation for improvements to Medicare payments to providers as well as recommendations on controls to help combat fraud and waste. As usual, MedPAC has concerns about home health and hospice and makes a... READ MORE

In the October 9, 2014 Federal Register, the Department of Labor (“DOL”) indicated it will delay enforcement of the Companion Services Rule (“Rule”) until June 30, 2015 (the “Notice”). The DOL suggests this delayed enforcement is meant to assist the provider community with implementing changes in the Rule. In its commentary, the DOL suggests... READ MORE

On April 21, 2014, Indiana’s Family and Social Services Administration (“FSSA”) offered a webinar for nursing facilities to provide additional information on Indiana’s Medicaid changes and Qualified Income Trusts (also known as Miller Trusts). READ MORE

Indiana’s Family and Social Services Administration continues its efforts to communicate, address and refine questions and issues related to the upcoming Medicaid coverage changes.  READ MORE