Volume 24.13
The drafted Hospice Care Accountability, Reform, and Enforcement Act (“Hospice Care Act”) would require the U.S. Department of Health and Human Services (“DHHS”) to impose a nationwide moratorium on the enrollment of hospice programs for a five (5) year period. The Secretary may exempt a new hospice from the moratorium if the hospice furnishes care in an area with insufficient access to hospice care.
During the five (5) year moratorium, the Secretary would be required to conduct prepayment medical reviews of routine home care claims submitted after the first ninety (90) day benefit period by hospices with aberrant billing patterns (e.g., high rates of live discharges). If a hospice has a low rate of denial, the Secretary may terminate the application of prepayment medical review.
Additionally, within six (6) months of the date of enactment, this subsection requires the Secretary to revalidate the enrollment information of each hospice program enrolled in Medicare and, no later than one (1) year after the date of enactment, publish the updated ownership interest and managing control information collected via revalidation.
The draft legislation would also extend the ability of the Secretary to establish provisional periods of enhanced oversight to two (2) years in the case of hospice programs (rather than one year under the existing statute). During a provisional period of enhanced oversight, providers and suppliers are subject to enhanced oversight, such as prepayment review and payment caps.
Regarding hospice sales, the draft would prohibit the hospice provider agreement and billing privileges to convey to a new owner within sixty (60) months of initial certification (or the last majority change in ownership), rather than the current thirty-six (36) months. Draft legislation is available here.
FEW SPOTS REMAIN FOR THE 2024 HOSPICE FINANCIAL ADMINISTRATION CONFERENCE
Only a few spots remain for the 2024 Hospice Financial Administration Conference (space is limited due to the nature of the program), scheduled for September 30 – October 1, 2024, at the Hilton Phoenix Tapatio Cliffs Resort in Phoenix, Arizona.
Special rates have been secured with the Hilton Phoenix Tapatio Cliffs Resort; however, to secure these rates, call (602) 866-7500 and inform the hotel that you are attending “The Health Group, LLC Hospice Financial Administration Conference” or, more conveniently, secure your room online at https://book.passkey.com/
Many benefits have been secured for conference attendees. If you have any problems securing your room at the discounted rates, do not hesitate to contact us at contact@healthgroup.com.
Speakers include professionals of The Health Group, LLC, Melinda Gaboury, co-founder and CEO of Healthcare Provider Solutions, Inc., and Bryan S. Bailey, Shareholder with Milligan Lawless (Phoenix office) who practices in healthcare fraud and abuse. Registration and other information are available at https://healthgroup.com/