Posted July 14, 2023
CMS is implementing a “period of enhanced oversight” for new hospices in California, Nevada, Arizona and Texas. A main component of the enhanced oversight includes a medical review of claims before a Medicare Administrative Contractor (MAC) will pay them.
This action was taken due to reports of potentially unethical or illegal practices among hospices, specifically among new companies popping up in those four states, which have spurred calls for stronger oversight from lawmakers and other stakeholders.
“CMS is placing newly enrolling hospices located in Arizona, California, Nevada, and Texas in a provisional period of enhanced oversight. Over the last 12 months, we’ve received numerous reports of hospice fraud, waste, and abuse,” the agency indicated in a Medicare Learning Network alert. “The number of enrolled hospices has also increased significantly in these states, raising serious concerns about market oversaturation.”
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