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

Shutdown is Over: The Pieces

The longest government shutdown in United States history concluded on November 12. Yesterday, I wrote a post summarizing the process until resolution – https://rhislop3.com/congress-medicaid-subsidies-whats-next/ Despite the cessation of the shutdown, pivotal issues—most notably the future of enhanced premium tax credits under the Affordable Care Act (ACA), which remain a point of contention for Democratic policymakers—are … Read more

CMS Releases Strategy on MAHA

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

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

Medicaid Spending Reductions, Part III

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

Medicaid Spending Reductions, Part II

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

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 1

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

Rural Healthcare Under Intense Pressure

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