Healthcare, Senior Living, Economics
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
My last post covered the legislative activity (Congress) concerning private equity’s role and investment in healthcare, particularly physician practices and hospitals https://rhislop3.com/legislation-restricting-pe-role-in-healthcare/ . Aside from legislation, a myriad of federal agencies are equally engaged. Federal Inquiry into Private Equity Control in Health Care In 2024, the Federal Trade Commission (FTC), the Department of Justice’s Antitrust … Read more
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
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
This is part three of the series of posts on hospice and home health fraud. Parts one and two can be accessed below. https://rhislop3.com/medicare-hospice-and-home-health-fraud-part-1/ https://rhislop3.com/medicare-hospice-and-home-health-fraud-part-2/ Recent Cases and Settlements in Medicare Fraud High-Profile Hospice Fraud Convictions Several recent cases highlight the persistence of fraudulent practices in hospice care billing under Medicare. One notable example involves … Read more
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
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
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
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
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