Medicaid Spending in the DOGE Radar

Introduction Mr. Musk’s DOGE team has requested access to CMS systems, which manage over $1 trillion in annual payments, according to documents obtained by the New York Times. This initiative, led by Mr. Musk’s longtime associate Steve Davis, aligns with a broader effort to reduce federal spending by scrutinizing payments and contracts. Hospital and health … Read more

Doc Payment Fix Bill in the Works?

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

DOJ Recovers $2.9 Billion in Fraud in 2024

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

Fixing Healthcare Spending in the U.S.

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

Senior Living Capital Outlook 2025

Since the pandemic (COVID), capital investment in senior living has been disjointed (to say the least). The pandemic constrained demand and as the economy rebounded from periods of lockdowns, supply shortages, work reductions, etc., inflation snuck in. In turn, to battle inflation, the Federal Reserve steadily raised interest rates. The rise in rates changed the … Read more

Federal Assisted Living Regulatory Initiative

Last week via a member news release from Leading Age Minnesota, the specter of federalized Assisted Living regulation popped up. Per this release, legislation enabling federal assisted living regulation of some form is anticipated to be proposed by U.S. Senator Mark Kelly (D-AZ) prior to the year’s end. The primary outcome of what Senator Kelly … Read more

CMS Issues Updates on Immediate Jeopardy

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

Being a More Effective Executive: A Checklist

Across my multiple decade career, I have spent a great deal of my work life mentoring and coaching executives and boards on developing effective habits and systems. As I have done a fair amount of turnaround work, building a high performing organization was as much about creating effective leaders and leadership habits as it was … Read more

Friday Feature: Four Topics to Watch

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

CMS Reinforces Hospice Regulatory, Fraud Focus

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