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CMS is Taking Action to Address Benefit Integrity Issues Related to Hospice Care

Briggs Healthcare

Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare Effective oversight and enforcement are important to protect the integrity of the Medicare program, especially for vulnerable, seriously ill individuals and their families. Unfortunately, hospices are profiting from fraud at the expense of beneficiaries far too often.

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What Problems has OIG Identified with the Hospice Program?

Briggs Healthcare

Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare Hospice care is for terminally ill patients who decide to forgo curative treatment and instead receive palliative care. Hospice care generally includes nursing and aide services, drugs, and supplies.

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Agency-Level Hospice Quality Measure (QM) Reports Now Include Claims-Based Measures

Briggs Healthcare

QM Reports now include two measures based on Fiscal Year 2018 and 2019 Medicare claims data: the Hospice Care Index (HCI) and Hospice Visits in the Last Days of Life (HVLDL). Hospices can use the QM Report to learn about HCI and HVLDL and begin efforts to improve quality of care.

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Inside 2 Emerging Risk-Based Home Care Models

Home Health Care

“Yes, we know that when we take on risk, we’re putting ourselves in a position that we might end up losing, but we’re creating opportunities so that we can actually move health care at home forward,” Resilient CEO Jackleen Samuel said during a presentation last month at the Home Care 100 conference.

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Hospices in Four States to Receive Extra Scrutiny Over Concerns of Fraud, Waste and Abuse

Briggs Healthcare

Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare “Last week, regulators rolled out enhanced oversight for new hospices in Arizona, California, Nevada and Texas. Some of these hospices obtained licenses only to sell them to other entrepreneurs. Some did both.

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Updated Information Gathering Report for Hospice Quality Reporting Program

Briggs Healthcare

Specific topics include treatment of moderate to severe pain, patient preferences, spiritual care, social needs, medication management, and other topics related to hospice quality. Many Americans rely on hospice care for end-of-life support. billion on hospice services (MedPAC, 2021). In 2019, more than 1.6

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Seven Steps for Building a Community-Based Palliative Care Benefit Within Medicaid

NASHP

Successful home-based palliative care programs cite an engagement rate of 35%. For length-of-stay estimates, consider using the CMMI Medicare Choices Model of community-based pre-hospice services, with an average length of stay of 99 days.