Former CMS employee: War on home care fraud yields 30 percent collateral damage
McKnights Home Care; by Liza Berger; 10/13/26
The recent uptick in fraud audits, denials and revocations may seem unusual, but it is not particularly new. One former Centers for Medicare & Medicaid Services employee said he has seen it before — in the late 1990s... [Michael McGowan, a former CMS Region IX OASIS automation coordinator] sees the current environment as the aftermath of Operation Restore Trust. While the federal government is claiming success in response to rampant fraud, McGowan believes it is just turning over the apple cart, bruising a lot of decent apples in the process. “There are gross amounts of provider fraud and there are gross amounts of collateral damage,” he said. “They do not have the ability to truly tell the difference. What they’ve done is gone after a bunch of small players. It looks really good to say, ‘Oh, we’ve just closed 500 agencies.’ Well, I know damn good and well you did not do it right. My CMS experience in the 20 years I’ve been doing this work shows me that there’s at least 30% collateral damage. That’s the norm. And they go crowing about their success while these people’s life work has been vaporized.”

How unexpected health crises can affect retirement savings and long-term wealth
The Clinton Courier [MS]; 10/13/26
Retirement planning usually focuses on building enough savings to support a comfortable life after leaving the workforce... Yet even a carefully prepared financial plan can face serious challenges when an unexpected health crisis occurs. A sudden injury, serious illness, or medical emergency can change a household’s financial priorities almost overnight. Money intended for retirement may need to cover hospital bills, rehabilitation, medications, or ordinary living expenses during a period without income. For some families, these costs create financial pressure that continues long after the immediate medical situation improves.
Publisher's note: Should hospices include financial discussions with patients and/or families as part of holistic care? Why or why not? If so, how...?

Where can Americans access palliative care? New national initiative aims to find out
Globe Newswire; by Elizabeth Dowling; 10/14/26
Where can people living with serious illness access specialty palliative care in the United States, and where is that care still out of reach? Today, there is no comprehensive national source showing where specialty palliative care is available across both hospital and community settings. The Center to Advance Palliative Care (CAPC) is working to change that with the launch of the Palliative Care Program Inventory (Program Inventory), a national initiative to map where specialty palliative care programs operate and where gaps in access remain. The Program Inventory will collect information directly from specialty palliative care programs nationwide, including data on staffing, patient volume, and care delivery models. The resulting data will support research, policy, and advocacy efforts to better understand - and ultimately expand - access to specialty palliative care across the country.

Morphine underused for end-of-life dyspnea in the emergency department compared with inpatient care
Medscape; 10/13/26
Among 250 patients presenting to the emergency department (ED) with dyspnea at the end of life, 15.2% received morphine in the ED, whereas 68% received it during subsequent inpatient care. Patients with lung cancer or a do-not-resuscitate order were more likely to receive morphine in the ED, but its use was not associated with reduced survival.
[This summary refers to [Jerusalem] Morphine for end-of-life dyspnea: Underuse in the emergency department versus inpatient care; Journal of Pain and Symptom Management; 9/26.]

As organ supply expands, equity must be reimagined
JAMA Network; by Lisa B. VanWagner, John Bucuvalas, David S. Goldberg, Ali Zarrinpar; 10/12/26
For decades, transplant has been defined by scarcity... That landscape is changing... Focusing on organ scarcity as the primary barrier to equitable transplant has obscured upstream inequities in referral, evaluation, and listing. Population-based analyses suggest that only a minority of patients dying with end-stage organ failure are evaluated for transplant. For example, the national waiting list for liver transplant is currently fewer than 9000 candidates, but this number represents only a small fraction of the estimated 70 000 to 75 000 annual deaths from cirrhosis in the US. Expanded supply may expose, rather than resolve, inequities that have long been obscured by scarcity.

Takeaways from an evaluation of Google’s diagnostic chatbot, AMIE
STAT by Mario Aguilar; 10/13/26
The Lancet last week published the results of a Google Research study, funded by Alphabet, with Beth Israel Deaconess Medical Center exploring the feasibility and safety of Google's company’s experimental diagnostic chatbot. In the study, roughly 100 urgent care patients chatted with Articulate Medical Intelligence Explorer, or AMIE, which created a list of possible diagnoses and management plans. The encounters with the chatbot were observed by a supervisor who could step in, and patients later saw a clinician.
Publisher's note: While I found both the STAT and Lancet articles a bit technical, it's fascinating to begin reading about studies using AI for patient diagnosis purposes. The STAT article may require a subscription; The Lancet journal article referred to is: Conversational diagnostic artificial intelligence in ambulatory primary care: a prospective feasibility study; 10/26.

Research: When being authentic undermines your leadership
Harvard Business Review; by Namrata Goyal, Krishna Savani, Sven Engesser, Veronika Job; 10/12/26
Leaders often assume that revealing a painful setback makes them appear more authentic to their employees. New research suggests the more powerful signal is agency: people respond more positively when leaders voluntarily disclose an unconventional choice that carried a personal cost. Across 10 experiments with more than 2,000 participants, such disclosures boosted perceived authenticity and support, especially for established leaders. By contrast, setbacks elicited sympathy but little authenticity, while exploitative choices damaged trust. The practical lesson is to distinguish vulnerability from authenticity, disclose choices rather than merely misfortunes, and build credibility before departing from convention at work.

SOS: Year 1 A 33 --Who are the hospices that were revoked in 2025?
Substack; by Joan Teno; 10/12/26
Medicare can take away a hospice’s right to bill, an action called revocation. In 2025 it revoked 209 hospices, most often for abusive billing or for ties to other providers that put Medicare at risk. Of the 173 that I could find in Medicare’s public quality data, nearly all were for-profit, about 9 in 10 were in California, and almost half had been certified for less than two years.I then asked a simple question: how many other hospices look like the ones that were revoked? ...

LA County fraud: Which 2026 scandal tops the list?
Film Daily; by Simone Barbon; 10/14/26
Los Angeles County’s 2026 docket of public-fund thefts keeps growing, and the dollar figures are hard to ignore. Homelessness contracts, Medi-Cal billings, and a landmark sex-abuse settlement now sit under overlapping state and federal probes that stretch from Culver City boardrooms to hospice billing offices. The cases together expose how oversight gaps turned routine county spending into slush funds and how recovery efforts may drag into 2027.

UnitedHealth reports $4.1B in profit, launches AI recommendations for Medicare Advantage plans
Becker's Payer Issues; by Elizabeth Casolo; 10/13/26
UnitedHealth Group reported $4.1 billion in profit for the third quarter of 2026, up 75% year over year, according to an Oct. 13 release... The company is also rolling out AI-powered plan recommendations for the upcoming Medicare Advantage annual enrollment period, CEO Stephen Hemsley said on the earnings call.

[Lisbon, Portugal] Closing the gap: Nurses call for action to pediatric palliative care
eHospice; by Joana Mendes; 10/12/26
On 6 October 2026, the Lisbon School of Nursing at the University of Lisbon hosted the international webinar “Closing the Gap: A Nursing Call to Action for Pediatric Palliative Care”, bringing together 112 participants, predominantly Portuguese nurses, around a shared commitment: advancing equitable, accessible and high-quality perinatal, neonatal and pediatric palliative care.

Fun fact: people with their next mountain trip planned are a lot happier than those who don't.