Medicare Hospice Fraud Is a Policy Failure
Medicare hospice fraud reflects weak oversight, distorted incentives, and rising compliance risk for operators, investors, and policymakers.
Healthcare, Senior Living, Economics
Medicare hospice fraud reflects weak oversight, distorted incentives, and rising compliance risk for operators, investors, and policymakers.
Home health compliance updates are getting sharper, faster, and more expensive to ignore. Here’s what operators should watch now in 2026.
A strong post acute care strategy aligns referrals, reimbursement, data, and risk so operators can compete under Medicare pressure and tighter scrutiny.
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
The Accreditation Commission for Health Care, Inc. (ACHC) has launched two new specialty credentials for organizations providing home care and/or hospice. These programs are in line with the Age-Friendly Health Systems (Care) programs and initiatives started by The John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI), in partnership with the American Hospital Association (AHA) and … Read more
The mandatory Transforming Episode Accountability Model (TEAM) will advance CMS prior work on value-based care models, including bundled care initiatives. The TEAM model (participation) will be mandatory for selected hospitals and participation “optional” for post-acute care providers. Transforming Episode Accountability Model (TEAM) | CMS The Transforming Episode Accountability Model (TEAM) is set to be a … Read more
TGIF! A frequent reader sent me a note earlier in the week and asked if I would drop in more clinically oriented stuff from time to time. I asked for details, and she said stuff “that is germane to patient care and operational improvements – QA/QI stuff”. So, today’s post is by request, sort of. … Read more
Happy Eclipse Monday! The post title is meant as a bit of fun but there is a bit of relevancy as well. Billing fraud occurs via a process of hiding what actually has transpired (or should have) with the care of a patient. The most typical fraud is overbilling or charging the government for care … Read more
On Tuesday, the Genworth 2023 Cost of Care Survey was released. Year-over-year rate increases in long-term care/senior living ranged from 1% to 10%, depending on the setting (SNF, Assisted Living, etc.). The report is available here: Genworth Cost of Care 2023 The report is interesting though in some ways, a bit misleading as data is … Read more
Today’s post is rather short by comparison to others. It is an adjunct to yesterday’s post regarding the credit market status for senior living and post-acute providers. Readers/followers that read the post will note that I included a fair amount of economic discussion, including some Federal Reserve minutes, to frame where I think rates and … Read more