Hospice

Post Acute Care Strategy That Holds Up

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Post Acute Care Strategy That Holds Up

A strong post acute care strategy aligns referrals, reimbursement, data, and risk so operators can compete under Medicare pressure and tighter scrutiny.

Medicare Reform Analysis Update

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The real Medicare reimbursement reform analysis starts with a hard truth: this is no longer a debate about payment mechanics. It is a debate about who absorbs risk, which care settings remain financially viable, and whether federal policy can restrain spending without destabilizing access. For operators in post-acute care, senior living, home health, hospice, and … Read more

CMS: Moratorium on Hospices and Home Health

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On May 13, 2026, the Centers for Medicare & Medicaid Services (CMS) imposed a nationwide six-month moratorium on new Medicare enrollments for hospice providers and home health agencies (HHAs). The action follows a recent executive order creating a federal task force to prevent fraud and disrupt fraud networks. Scope of the Action The new restrictions … Read more

Medicare Hospice TPE Basics and Update

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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

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 Reinforces Hospice Regulatory, Fraud Focus

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Yesterday, CMS dropped a memo to state survey agencies titled, “Ensuring Consistency in the Hospice Survey Process to Identify Quality of Care Concerns and Potential Fraud Referrals”. The memo is available here: qso-25-06-hospice According to CMS, the memorandum aims to bolster current mechanisms for detecting instances where a hospice provider’s failure to adhere to the … Read more