News Alerts
LEGISLATION INTRODUCED TO CONTINUE OVERSIGHT OF HOME HEALTH AND HOSPICE PROVIDERS
Volume 26.07
On May 20, 2026, the “Protecting Seniors and Stopping Fraudsters Act” (“ACT”) was introduced in the House of Representatives.
The proposed legislation, if enacted, would provide:
Increased survey frequency for newly ...
CMS ANNOUNCES NATIONAL MORATORIUM
Volume 26.06
Effective today, May 13, 2026, the U.S. Centers for Medicare & Medicaid Services (“CMS”) has issued a Notice and imposed a national six (6) month moratorium on the Medicare enrollment of hospices.
Beginning on May 13, ...
CMS ANNOUNCES NATIONAL MORATORIUM
Volume 26.01
Effective today, May 13, 2026, the U.S. Centers for Medicare & Medicaid Services (“CMS”) has issued a Notice and imposed a national six (6) month moratorium on the Medicare enrollment of home health agencies.
Beginning on May ...
HOSPICE CARE ACT REINTRODUCED
Volume 26.05
The Hospice Care Accountability, Reform, and Enforcement Act (“Hospice Care Act”) has been reintroduced.
The Hospice Care Act contains numerous program integrity provisions and payment reforms. It would establish new ...
NATIONAL GOVERNMENT SERVICES CHANGES NAME
Volume 26.01
National Government Services (“NGS”) will begin operating as Wellpoint Federal effective April 1, 2026. Beginning April 1, 2026, NGS will begin transitioning and there are no immediate changes to the provider portals, NGSConnex ...
MEDPAC RECOMMENDS NO HOSPICE PAYMENT UPDATE FOR FY 2027
Volume 26.03
On March 12, 2026, the Medicare Payment Advisory Commission (“MedPAC”) issued its March 2026 Report (“Report”) to Congress. The Report includes one recommendation, “For fiscal year 2027, the Congress should eliminate the update ...
HOSPICE FRAUD AND ABUSE TAKES CENTER STAGE AGAIN
Volume 26.02
The U.S. Centers for Medicare & Medicaid Services (“CMS”), as well as states are actively looking at efforts to strengthen program integrity across all Medicare and Medicaid programs, including hospice. Hospice providers ...
HOSPICE FINANCIAL ADMINISTRATION PROGRAM
Volume 26.01
The California Hospice and Palliative Care Association (“CHAPCA”) and The Health Group, LLC are jointly providing the CHAPCA Hospice Financial Administration Program, scheduled for March 24-25, 2026, at California State University ...
LEGISLATION IN NEW YORK TO BAN NEW FOR-PROFIT HOSPICES VETOED
Volume 25.12
The New York Assembly passed legislation in December 2025 that would have prohibited the establishment of any new for-profit hospices in the State of New York; however, the legislation has been vetoed by the Governor due to low ...
DMEPOS INTEGRITY PROVISIONS STRENGTHENED
Volume 25.10
CMS has taken steps to increase program integrity of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (“DMEPOS”) providers in the recently finalized “Calendar Year (CY) 2026 Home Health Prospective Payment System ...
MEDICARE IS NOT THE ONLY PROGRAM THAT LIMITS PAYMENTS TO HOSPICES
Volume 25.11
Over twenty percent (20%) of hospices are now being subjected to Medicare program repayments because of the aggregate payment limitation (“CAP”).
Recently, we reported that the Office of Inspector General (“OIG”) determined ...
SKILLED NURSING REVALIDATION DUE JANUARY 1, 2026
Volume 25.09
Skilled nursing facility (“SNF”) providers enrolled in the Medicare program or dually enrolled in the Medicare/Medicaid programs must submit a mandatory off-cycle provider enrollment revalidation or risk having their enrollment ...
CMS DEVELOPING HOSPICE SPECIFIC WAGE INDEX FOR ADUSTING HOSPICE PAYMENTS
Volume 25.10
Abt Global, working on behalf of the Centers for Medicare & Medicaid Services (“CMS”), hosted a panel of technical experts to discuss hospice wage index reform.
Hospices have expressed concerns regarding the use of the ...
CGS DID NOT REOPEN AND RECALCULATE HOSPICE CAP LIABILITIES
Volume 25.10
The Office of Inspector General, Department of Health and Human Services (“OIG”) has completed its audit of all three hospice Medicare Administrative Contractors (“MACs”) regarding the calculation of hospice CAP liabilities and ...
CMS CUTS IN HOME HEALTH PAYMENTS AND COVID CAUSE DECLINE IN HOME HEALH SERVICES
Volume 25.03
The home health industry is standing firm in its criticism of the Home Health Proposed Rule which will again significantly reduce payments to home health agencies effective January 1, 2026.
CMS’s own data reports that over 1,000 ...
MedPAC UPCOMING PUBLIC MEETING
Volume 25.09
MedPAC’s September 2025 public meeting will be available via live webcast on Thursday, September 4th and Friday, September 5th. The sessions are as follows:
Medicare payment operations and improving payment accuracy,
...
NO TAX ON OVERTIME? – NOT EXACTLY
Volume 25.08
Healthcare providers of all types pay certain employees who are eligible for overtime pay. The One Big Beautiful Bill Act (“OBBBA”) has been advertised as eliminating federal income tax on overtime pay; however, employers and ...
CMS RELEASES HOSPICE FINAL PAYMENT RULE
Volume 25.08
On August 1, 2025, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (CMS-1835-F) that updates Medicare hospice payment rates and the aggregate cap amount for fiscal year (FY) 2026, which begins on ...
SKILLED NURSING FACILITY MEDICARE ENROLLMENT REVALIDATIONS
Volume 25.07
Skilled Nursing Facilities (“SNF”) that had an August 1, 2025, due date for submission of their CMS-855A revalidation has been pushed back to January 1, 2026.
The Form CMS-855A was revised to collect the SNF data addressed in ...
UPDATED REQUESTS FOR EXTENDED REPAYMENT SCHEDULES
Volume 25.07
Many hospice providers request an Extended Repayment Schedule (“ERS”) to liquidate outstanding Medicare program liabilities, which are primarily the result of a CAP overpayment. If repaying the overpayment within thirty (30) days ...
2026 HOME HEALTH PROPOSED RULE PUBLISHED
Volume 25.02
The U.S. Centers for Medicare & Medicaid Services (“CMS”) has released the 2026 Home Health Proposed Rule. The Proposed Rule is available in its entirety here.
The Proposed rule includes:
A reduction in Medicare home ...
ALLIANCE RELEASES FINDINGS CONCERNING HOME HEALTH CARE ACCESS
Volume 25.06
The National Alliance for Care at Home (“Alliance”), in partnership with KNG Health, has published findings related to deteriorating access by Medicare program beneficiaries to home health care. Key findings include:
“Since ...
REGISTRATION NOW AVAILABLE FOR HOSPICE FINANCIAL ADMINISTRATION CONFERENCE
Volume 25.06
The Health Group, LLC is pleased to announce that registrations are now being accepted for the 2025 Hospice Financial Administration Conference scheduled for October 16-17, 2025. The conference will be held at the Hilton ...
CMS ISSUES PROPOSED RULE RELATED TO PROVIDER TAX BY STATES
Volume 25.05
For many years, states have imposed broad-based taxes on healthcare providers. These taxes were used by the respective states to secure additional federal funding to support Medicaid payments to those healthcare providers. These ...
MedPAC RECOMMENDS ADDITIONAL HOME HEALTH PAYMENT REDUCTIONS
Volume 24.06
The Medicare Payment Advisory Commission (“MedPAC”) in its March 2025 Report to Congress has again recommended that the 2026 payment rates for home health agencies should reflect a seven percent (7%) reduction to the 2025 ...
CMS ISSUES MULTIPLE PROPOSED RULES
Volume 25.04
On Friday, April 11, 2025, the U.S. Centers for Medicare & Medicaid Services (“CMS”) released numerous proposed rules encompassing multiple types of providers.
Fiscal year 2026 Hospice Wage Index and Payment Update - On April ...
CMS RELEASES PROPOSED PAYMENT UPDATE
Volume 25.05
On Friday, April 11, 2025, the U.S. Centers for Medicare & Medicaid Services (“CMS”) released the Fiscal Year (FY) 2026 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, and Hospice ...
HHS Announces Restructuring and Cost Reduction
Volume 25.03
On March 27, 2025, the U.S. Department of Health and Human Services (HHS) announced a dramatic restructuring in accordance with President Trump's Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ ...
TELEHEALTH EXTENDED
Volume 25.04
The Full-Year Continuing Appropriations and Extension Act of 2025 (FY 2025) “ACT”), recently passed by Congress allows for the continuation of many programs. Telehealth flexibilities for hospice have been extended through ...
MEDICARE ADMINISTRATIVE CONTRACTORS NOT MEETING MEDICARE COST REPORT OVERSIGHT REQUIREMENTS
Volume 25.02
MEDICARE ADMINISTRATIVE CONTRACTORS NOT MEETING MEDICARE COST REPORT OVERSIGHT REQUIREMENTS
The Office of Inspector General of the Department of Health and Human Services (“OIG”) Office of Audit Services has released “Medicare ...
OIG COMPLIANCE PROGRAM GUIDANCE FOR NURSING FACILITIES; HOSPICE ARRANGEMENTS
Volume 25.03
Hospices must generally furnish all core hospice services themselves and not by independent contractors. However, hospices may furnish noncore services under arrangements with other providers or suppliers, including nursing ...
REVISED CMS-855A MUST BE USED FOR ALL ENROLLMENT SUBMISSIONS
Volume 25.01
The Form CMS-855A was revised in September 2024. Effective October 1, 2024, all skilled nursing facility (“SNF”) providers must use the revised form for all enrollment applications and updates. Other Part A providers are ...
HOSPICE SPECIAL FOCUS PROGRAM HALTED
Volume 25.02
Implementation of the highly controversial hospice Special Focus Program (“SFP”) has been suspended by the Trump Administration.
SFP, which was part of the 2024 home health payment rule, was intended to identify poor ...
HOSPICE CAP SELF-REPORTING
Volume 25.01
All hospices that were certified on or before October 1, 2023, are required to submit a Self-Determined Hospice CAP (“SDHC” or “CAP”) Report on or before February 28, 2025. The CAP Report will generally cover claims for the ...
MANY HOSPICES CLAIMS REJECTED DUE TO PECOS FILE ERROR
Volume 24.16
Many hospices have experienced claim rejections resulting significant cash-flow disruptions because of reporting the certifying physician which did not match information in the Provider Enrollment, Chain and Ownership System ...
MEDICARE 2025 HOME HEALTH PAYMENT RATES RELEASED
The U.S. Centers for Medicare & Medicaid Services (“CMS”) has released final 2025 home health payment rates. The national standardized 30-day period payment amount has been computed as follows:
2024 National Standardized 30-day ...
HOSPICE CARE ACT OF 2024 INTRODUCED
Volume 24.15
HOSPICE CARE ACT OF 2024 INTRODUCED
On Wednesday, Representative Earl Blumenauer introduced legislation, the Hospice Care Accountability, Reform, and Enforcement Act (“Hospice CARE Act”), which represents what would be the most ...
HOSPICE PREPAYMENT REVIEW EXPANDED
Volume 24.14
The Centers for Medicare & Medicaid Services (“CMS”) has announced that prepayment medical review will be expanded in California, Arizona, Texas, and Nevada. The expansion will reach existing providers; however, a small ...
DRAFT LEGISLATION WOULD IMPACT HOSPICE MEDICARE ENROLLMENT AND SALE
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 ...
GUIDANCE ON TERMINATING VBID HOSPICE COMPONENT RELEASED
Volume 24.12
On August 7, 2024, the Centers for Medicare & Medicaid Services (“CMS”) issued guidance regarding the termination of the VBID Hospice Component. The guidance is available at CY2024 VBID-Hospice Technical and Operational ...
HOSPICE CARE ACT REPRESENTS MOST SIGNIFICANT CHANGES SINCE HOSPICE BENEFIT ESTABLISHED
Volume 24.11
While the drafted Hospice Care Accountability, Reform, and Enforcement Act (“Hospice Care Act”) is generally regarded as a continuation of efforts to target bad actors operating in the hospice space, it would not only ...
PROVIDER OWNERSHIP, AFFILIATION DISCLOSURES AND OTHER INTEGRITY MEASURES CONTINUE TO CONSUME MORE PROVIDER RESOURCES
Volume 24.01
The Centers for Medicare & Medicaid Services (“CMS”) has continually been concerned regarding how to identify “bad actors”, their continued involvement with Medicare providers, and the appropriate response to inappropriate ...
SMALLER PROPRIETARY HEALTHCARE PROVIDERS MAY BE REQUIRED TO REPORT TO DEPARTMENT OF THE TREASURY
Volume 24.04
In 2021, Congress enacted the bipartisan Corporate Transparency Act to curb illicit finance. This law requires many companies doing business in the United States to report information about who owns or controls ...
THE HOSPICE CARE ACCOUNTABILITY, REFORM, AND ENFORCEMENT ACT OF 2024 WOULD ELIMINATE PAYMENT FOR CERTAIN AIDE AND HOMEMAKER SERVICES
Volume 24.10
The Hospice Care Accountability, Reform, and Enforcement Act of 2024 (“Hospice CARE Act of 2024”), currently in draft form, would eliminate coverage of certain aide and homemaker services. The draft legislation would make the ...
NAHC AND NHPCO SIGN AFFILIATION AGREEMENT
Volume 24.09
The two largest organizations representing home care providers, the National Association for Home Care & Hospice (“NAHC”) and the National Hospice and Palliative Care Organization (“NHPCO”), signed an affiliation agreement on ...
NAHC AND NHPCO SIGN AFFILIATION AGREEMENT
Volume 24.03
The two largest organizations representing home care providers, the National Association for Home Care & Hospice (“NAHC”) and the National Hospice and Palliative Care Organization (“NHPCO”), on June 10, 2024, signed an ...
DRAFT HOSPICE LEGISLATION WOULD SUBSTANTIALLY CHANGE ENROLLMENT, COMPLIANCE, AND PAYMENTS
Volume 24.08
Yesterday, Congressman Earl Blumenauer released a discussion draft of legislation that would, if enacted, substantially modify hospice enrollment, compliance, and Medicare payments.
We will be making an extensive review of the ...
2024 HOSPICE FINANCIAL ADMINISTRATION CONFERENCE SCHEDULED
Volume 24.07
The Health Group, LLC has scheduled the 2024 Hospice Financial Administration Conference for September 30 – October 1, 2024. The two-day program will be held at the Hilton Phoenix Tapatio Cliffs Resort in Phoenix, ...
VBID AND HOSPICE CAP CALCULATIONS
Volume 24.06
Hospices that have and are currently participating in the VBID Model Hospice Benefit often inquire as to the impact on their aggregate payment limitation (“CAP”) caused by patients served through the VBID contract. VBID ...
NAHC/HHFMA REQUESTS ASSISTANCE IN ADDRESSING MEDICARE ADVANTAGE AND HOME HEALTH AGENCY RELATIONSHIPS
Volume 24.02
The National Association for Home Care and Hospice (“NAHC”) is initiating a landmark survey focusing on the operational and financial aspects of the relationship between home health agencies and Medicare Advantage (“MA”) plans. ...
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