Healthcare, Senior Living, Economics
On December 29, 2025, the Centers for Medicare & Medicaid Services (CMS) announced the inaugural state awards from the $50 billion Rural Health Transformation Program CMS Announces $50 Billion in Awards to Strengthen Rural Health in All 50 States | CMS. The program was created as a policy vehicle to mitigate the potential negative effects … Read more
As of January 1, 2026, the scope of Medicare’s site-neutral payment policy expands to include drug administration services—such as chemotherapy and other infused therapies—furnished in excepted (grandfathered) off-campus provider-based departments (PBDs) of hospitals. Under the CY 2026 OPPS final rule published by CMS: CY 2026 OPPS and Ambulatory Surgical Center Final Rule – Hospital Price … Read more
Within the last few weeks, I’ve had the opportunity to discuss and review, the ongoing Medicare TPE program with a number of hospices and hospice folks. Suffice to say, there are more than a few questions and resultant (still) confusion over the audit process and claims denial in general. I hope this post provides some … Read more
Last week, I wrote a couple of posts regarding Medicaid, the Affordable Care Act/insurance premium subsidies and the government shutdown. The second of the two posts contained a quick summary of the shutdown impact on Hospital-at-Home programs. https://rhislop3.com/shutdown-is-over-the-pieces/ This post elaborates further on the Hospital-at-Home program, the end of the waiver, the end of the … Read more
The Centers for Medicare & Medicaid Innovation (Innovation Center), formerly known as CMMI and part of the Centers for Medicare & Medicaid Services (CMS) under the US Department of Health & Human Services (HHS), has released a White Paper (CMS Innovation Center Strategy to Make America Healthy Again | CMS ) outlining a strategic direction … Read more
I had a chance today to visit with Daniel Horowitz on his podcast regarding healthcare spending, healthcare reform, health policy and economics. We a had a great discussion. The podcast link is below. Feel free to share with others as you all see fit. Why Health Care Sucks and What Ought to Be Done If … Read more
Policy Options and Alternatives to Reduce Medicaid Costs This is part three of a series I wrote on Medicaid spending reductions (proposed). Recent Republican budgets have targeted Medicaid for $800 plus billion in spending reductions. This final post in the series covers the likely choices available from a policy perspective, to achieve the savings target. … Read more
Potential Impacts of Medicaid Cuts on Beneficiaries and Providers This is Part II of a series I researched and produced on Medicaid cuts. The third, which I will edit and post later in the week, will wrap it up. With healthcare spending a major economic issue, I hope these few posts provided context for readers … Read more
This is part three of the series of posts on hospice and home health fraud. Parts one and two can be accessed below. https://rhislop3.com/medicare-hospice-and-home-health-fraud-part-1/ https://rhislop3.com/medicare-hospice-and-home-health-fraud-part-2/ Recent Cases and Settlements in Medicare Fraud High-Profile Hospice Fraud Convictions Several recent cases highlight the persistence of fraudulent practices in hospice care billing under Medicare. One notable example involves … Read more
Late last week, I posted the first part of a three-post, comprehensive review of Medicare hospice and home health fraud. Medicare home health and hospice billing fraud has emerged as a significant issue within the U.S. healthcare system, costing taxpayers billions of dollars annually and jeopardizing the integrity of federal health programs. This is part … Read more