House Legislation Takes Aim at CMMI Models

Bill Presses for Greater Transparency, Strengthened Oversight Key members of two House committees with jurisdiction over Medicare and Medicaid have introduced legislation to increase oversight and accountability of the Centers for Medicare & Medicaid Innovation (CMMI). CMMI is the division of the Centers for Medicare & Medicaid Services (CMS) having broad authority to test innovative…

HHS Warns of Potential Cyber Threat to Health Care Entities

Below is an announcement from the HHS Office for Civil Rights related to a cyber threat potentially impacting healthcare and public health (HPH) sector entities. The purpose of this bulletin is to notify you of a number of vulnerabilities identified in Microsoft Windows operating systems which if not addressed, pose significant threat to the environment.…

OIG Report on Hospice Aide Supervisory Visits

Deficiencies found and remedies recommended by OIG The Department of Health and Human Services’ (HHS) Office of the Inspector General (OIG) recently released another report pertaining to the quality of hospice care.  In this report, Registered Nurses Did Not Always Visit Medicare Beneficiaries’ Homes At Least Once Every 14 Days To Assess The Quality Of…

‘Conscience Rule” Vacated

As reported in NAHC Report in July 2019, the U.S. Department of Health and Human Services (HHS) agreed to postpone the effective date of the Protecting Statutory Conscience Rights in Health Care; Delegations of Authority  rule. The rule, commonly referred to as “the conscience rule”, was set to take effect in July and had been delayed…

OIG Report Recommends CMS Use CERT Data to Identify High Risk Home Health Agencies

CMS Remains Opposed to Using CERT Data to Identify Improper Payments, Prefers TPE & RCD The Health and Human Services (HHS) Office of the Inspector General (OIG) recently released a report pertaining to home health agencies (HHA), The Centers for Medicare & Medicaid Services Could Use Comprehensive Error Rate Testing Data To Identify High-Risk Home…

CMS Schedules Listening Session on Opioid Prescriber Accountability

In October 2018, President Trump signed the SUPPORT for Patients and Communities Act into law; in doing so, he enacted sweeping legislation designed to address the nationwide scourge of opioid abuse.  Among the numerous provision of interest to the hospice community included in the new law was authority for hospices, under specific circumstances, to allow…

OIG Finds Medicare Part D Still Spending Millions for Hospice Drugs

Over recent years the Department of Health & Human Services Office of the Inspector General (OIG) and others have conducted analyses of spending outside of hospice while patients are on service and determined that Medicare may be paying separately for care (including prescription drugs under Part D) that should be the responsibility of the hospice. …

OIG Report Finds States Need to Do More on Background Checks for Long-Term Care Workers

A new report from the Office of Inspector General (OIG) of the Department of Health and Human Services finds that nine of the 11 states that concluded their participation in the National Background Check Program in 2017 and 2018 did not implement all of the selected Program requirements, primarily due to a lack of legislative…

Controversial “Conscience Rights” Rule Delayed

The U.S. Department of Health and Human Services (HHS) has agreed to postpone the effective date of the Protecting Statutory Conscience Rights in Health Care; Delegations of Authority  rule.  The rule, commonly referred to as “the conscience rule”, was set to take effect this month and has been delayed by at least four months to…

HHS Renews Settlement Conference Facilitation for Appeal Resolutions

The Department of Health and Human Services (HHS) has renewed its Settlement Conference Facilitation (SCF) program. The SCF is available to all Medicare Part A and Part B providers and suppliers with appeals pending at the Administrative Law Judge (ALJ) or the Medicare Appeals Council (Council) level. The appeals must have been filed on or…