Medicare Hospice TPE Basics and Update

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

Hospital-at-Home Waiver Ended – What Next?

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

Congress, Medicaid Subsidies – What’s Next

The Senate has approved a spending bill to keep the federal government running through January 30, though any decisions about extending the ACA enhanced premium tax credits have been postponed until December. Here are the main highlights: The package, passed with a 60-40 vote, will fund the Department of Agriculture, Food and Drug Administration, and … Read more

CPI and Healthcare Inflation

This past week the Bureau of Labor Statistics (BLS) released May’s CPI (inflation) report.  Overall, the trend is improving with inflation now, month over month, increasing .1% vs. .2% in April.  On a 12 month basis, inflation has risen 2.4% (not seasonally adjusted). See below. Of the items that continue to run “hotter” than overall … Read more

Republican House Medicaid Reform Package

Overview On May 11, House Republicans introduced a 160-page (Subtitle D Health Ae3638d840 | PDF | Medicaid | Federal Government Of The United States)  bill aiming to implement nationwide Medicaid work requirements and stricter eligibility standards. The legislation, part of a broader budget reconciliation package, seeks to cut federal spending by hundreds of billions of … Read more

VOHRA Wound Care Faces Medicare Fraud Claim

The U.S. Department of Justice (DOJ) filed a False Claims Act lawsuit on April 4, 2025, against Vohra Wound Physicians Management LLC, Dr. Ameet Vohra, and VHS Holdings, P.A., in the U.S. District Court for the Southern District of Florida (Case No. 25-cv-21570). The complaint alleges that since December 2017, Vohra engaged in a nationwide … Read more

Podcast on Healthcare Spending and Reform

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

Medicaid Spending Reductions: What to Know

Medicaid potential spending cuts have been in the news, elevated by the passage of the recent Republican Continuing (spending) Resolution. As Donald Trump ran and got elected on a platform of spending reduction/debt reduction (austerity) including the activation of DOGE (Dept. of Government Efficiency) to identify spending reduction opportunities, program behemoths like Medicare and Medicaid … Read more

Medicare Hospice and Home Health Fraud, Part 2

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

House GOP Releases Budget Blueprint for Savings

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