Home Health

Medicare Hospice and Home Health Fraud, Part 3

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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

Medicare Hospice and Home Health Fraud, Part 2

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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

Medicare Hospice and Home Health Fraud, Part 1

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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. Fraudulent practices in this sector not only drain public resources but also compromise the quality of care provided to vulnerable populations, including the … Read more

DOJ Recovers $2.9 Billion in Fraud in 2024

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The Department of Justice (DOJ) announced that the agency recovered $2.9 billion in resolutions to federal False Claims Act allegations for 2024 (fiscal year ending September 30).  This is a slight increase from the historic $2.7 billion recovered in fiscal year 2023. Office of Public Affairs | False Claims Act Settlements and Judgments Exceed $2.9B … Read more

CMS Releases Home Health Final Rule 2025

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On November 1 the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year 2025 Home Health Prospective Payment System (HH PPS) final rule, which updates Medicare payment policies and rates for Home Health Agencies.  Unlike other Medicare provider types that have PPS rule updates corresponding to the federal fiscal year (10/1), home health … Read more

Federal Judge Key Ruling on False Claims Act

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On September 30, US District Judge Kathryn Kimball Mizelle from the Middle District of Florida ruled in a landmark decision that the qui tam provision of the federal False Claims Act (FCA) is unconstitutional. This ruling could have significant impact on whistleblower (Qui Tam) actions filed against healthcare providers, particularly home health and hospice (most … Read more

Nursing Assistants = Supply Shortage

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Nursing assistants are anticipated to experience the largest projected shortfall among all healthcare occupations analyzed, with an expected national shortage exceeding 73,000 assistants by 2028. This projection is based on a report by Mercer, which also predicts a nationwide deficit of over 100,000 healthcare workers by the same year. The demand for nursing assistants is … Read more

Exploring Age-Friendly Healthcare Programs

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The Accreditation Commission for Health Care, Inc. (ACHC) has launched two new specialty credentials for organizations providing home care and/or hospice.  These programs are in line with the Age-Friendly Health Systems (Care) programs and initiatives started by The John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI), in partnership with the American Hospital Association (AHA) and … Read more

TEAM Model and Post-Acute Care

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The mandatory Transforming Episode Accountability Model (TEAM) will advance CMS prior work on value-based care models, including bundled care initiatives. The TEAM model (participation) will be mandatory for selected hospitals and participation “optional” for post-acute care providers. Transforming Episode Accountability Model (TEAM) | CMS The Transforming Episode Accountability Model (TEAM) is set to be a … Read more

Senior Housing and Care M&A at Record Level

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Mergers and acquisitions activity in the seniors housing and care sector set a new quarterly record with 183 publicly announced transactions in the second quarter of 2024, as reported by LevinPro LTC. This represents a 21% increase over the 151 transactions from the first quarter of 2024, and a 49% rise compared to the 123 … Read more