Healthcare, Senior Living, Economics
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
Introduction House Republicans released a budget blueprint on February 12th that directs the Energy and Commerce Committee to achieve $880 billion in savings from fiscal years 2025 through 2034. GOP Budget Reconciliation Bill Draft Budget Overview The budget resolution does not provide specific instructions on how the committee should achieve the $880 billion in savings. … Read more
According to a Feb. 11 report by Chartis, 432 rural hospitals are at risk of closure. Chartis analyzed 15 indicators and identified 10 significant predictors, including Medicaid expansion status, average length of stay, occupancy, changes in net patient revenue, and years of negative operating margin. The full report is available here: CCRH WP – 2025 … Read more
A bipartisan group of House representatives introduced a bill on Friday aimed at addressing and exceeding a pay cut for doctors that took effect at the beginning of this year. The legislation, known as the Medicare Patient Access and Practice Stabilization Act of 2025, seeks to mitigate the financial strain on physicians caused by the … Read more
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
On Monday, January 20, Donald Trump will be inaugurated as the 47th president of the U.S. While his claim of an election mandate is very debatable, the expectations that come with his return to office are many. Chief among these expectations is that he/his administration will “fix” the debt driven, inflation riddled economy of the … Read more
A Colorado federal judge last Wednesday certified a class of stockholders in a securities suit against InnovAge (https://www.innovage.com/) alleging the senior health care company made misleading statements in its initial public offering that later caused stock prices to fall post a government audit that exposed false statements. Three public pension funds based in Texas and … Read more
Back in 2019, CMS issued revisions to Appendix Q of the State Operations Manual pertaining to Immediate Jeopardy considerations (on the part of surveyors) and ultimately, citation decisions. This guidance was relevant for all provider and supplier types participating in Medicare (hospitals, home health, SNFs, etc.). In late October, CMS issued guidance on penalties. What … Read more
It has been a busy week and next week is a holiday week (Thanksgiving) so of course, a shortened news and work week. That said, there is a lot going on right now and for followers and readers, I thought sharing my top four topics to watch made sense. Tort Reform: Back in February, the Georgia … Read more
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