Glendale woman and Lakewood man found guilty of $3.2 million hospice fraud scheme involving kickbacks for patient referrals 
United States Attorney's Office - Central District of California, Los Angeles, CA; Press Release; 12/12/24
A Glendale woman and a Lakewood man have been found guilty by a jury of paying and receiving hundreds of thousands of dollars in illegal kickbacks for patient referrals that resulted in the submission of approximately $3.2 million in fraudulent claims to Medicare for purported hospice care, the Justice Department announced today. Nita Palma, 75, of Glendale, was found guilty late Wednesday of 12 counts of health care fraud and 16 counts of paying illegal kickbacks for health care referrals. Percy Abrams, 74, of Lakewood, also was found guilty late Wednesday of six counts of receiving illegal kickbacks for health care referrals. ... Consistent with instructions provided by Palma, Abrams falsely represented to prospective patients that they did not need to be dying to be on hospice. After collecting personal identifying information from prospective patients that were not dying, Abrams sent the information to Nita Palma so she could bill Medicare for purported hospice care.
Editor's note: Caution. How many hospices have misused information about President Jimmy Carter's long Length of Stay (LOS) to purport similar messaging that "hospice is not about dying"? Too often, articles we would review used "not about dying" language and never mentioned anything about ongoing clinical review for hospice appropriateness, 6-month Face to Face visits, et al. 

‘Open door’ policy for staff key to preventing hospice False Claims Act complaints 
Hospice News; by Jim Parker; 12/13/24 
Taking employee concerns seriously about patient eligibility and other issues can help prevent hospices from becoming involved in a False Claims Act case. The overwhelming majority of False Claims Act cases involve qui tam whistleblowers, usually a current or former employee who observed alleged malfeasance or errors. In a qui tam action, a whistleblower, called a “relator” by the courts, files a False Claims Act suit on behalf of the government and possibly receives a portion of any funds recovered by the government via the lawsuit, typically ranging from 15% to 25%. In Fiscal Year 2023, for example, these cases recovered $2.3 billion of the total $2.68 billion recouped by the government in FCA settlements and judgements, according to a report from the law firm Polsinelli.

Embracing life when nearing death 
The Aspen Times - Snowmass Sun; Aspen, CO; by Allison Daily; 12/13/24 
Receiving a terminal diagnosis is one of life’s most profoundly difficult moments — a collision of disbelief, fear, and uncertainty. With some diseases, there’s a glimmer of hope for a miracle; with others, the focus shifts to navigating the process ahead. When Rita Hunter first asked to meet with me, I had no idea she had been diagnosed with Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig’s Disease. As we settled into my office, she got straight to the point: “I want you to help me with this last part of my life.” I left our first session rattled, but we established a clear understanding over time. She needed someone with whom she could be brutally honest — someone to discuss, without judgment, what she was willing and unwilling to endure. ... In her final days, her body let her know when it was time, and she showed extraordinary grace. She was a gift to this community, and she was a gift to me. She taught me more than I could ever give to her. Rita had become a model of how to live fully, even in the face of an unchangeable reality. 
Editor's note: Click on the title's link to read this inspirational story, and to learn this clinician's "treehouse" imagery intervention.

What they love and loathe: Medscape Nurse Career Satisfaction Report 2024 
Medscape; by Jon McKenna; 12/13/24 
Despite well-publicized issues buffeting their profession, nurses in a Medscape survey overwhelmingly said they are happy with their career choice, and most said they would make it again. They also told us about their most- and least-favored job features, recounted any experiences with abuse at work, revealed possible alternative careers, and reported union membership, among other insights. [Click on the title's link to continue reading.]

You heard that correctly: Scammers are committing hospice fraud 
Federal Trade Commission - Consumer Advice; by Kira Krown, Consumer Education Specialist; 12/13/24 
Did someone reach out and offer free, in-home perks like cooking and cleaning in exchange for your Medicare number? Don’t give it. That could be a scammer trying to commit hospice fraud.Scammers are targeting older adults — with calls, texts, emails, fake ads, and even door-to-door visits — claiming they’ll set you up with services like free cooking, cleaning, and home health care. What they likely won’t tell you is how: They want to commit fraud by signing you up for Medicare hospice — that’s right, hospice — care. Then, they can bill Medicare for all kinds of services in your name. Here’s what to know: ..
Editor's note: Share this crucial information information from the Federal Trade Commission with the communities you serve, your employees, and your volunteers. 

Beshear unveils paid leave plan for state workers with new child or serious illness 
Spectrum News 1, Frankfort, KY; by Associated Press; 12/12/24 
Kentucky plans to provide state employees with paid time off so they can bond with a new child or deal with a serious medical situation, Gov. Andy Beshear, D-Ky., said Thursday. The added benefit will give state executive branch workers up to six weeks of paid leave, available in three intervals during an employee's career, the governor said. New hires will immediately become eligible for six weeks of paid time off, he said. Another six weeks of paid leave will be offered two more times: once employees reach 10 years of service and again at 20 years. 

ONA accuses Providence of trying to sidestep state regulators as it partners with private equity 
Oregon Nurses Association; by ONA; 12/12/24 
The Oregon Nurses Association (ONA) sent a letter to the Oregon Health Authority asking them to intervene in the recently proposed joint venture between Providence Health and private equity-backed Compassus to manage Providence’s home health and hospice program. The full letter is included below. Providence announced the so-called joint venture in October but has failed to file the proper paperwork with Oregon’s Healthcare Market Oversight (HCMO) to allow state regulators time to review the sale. Concerns from patients and caregivers have already been raised about transparency, patient care, and the potential negative effects on health outcomes in Oregon’s vulnerable communities with this joint venture.

Humana in the headlines: 10 updates 
Becker's Payer Issues; by Andrew Cass; 12/10/24 
From Cigna quashing merger speculation to naming a new CFO, here are 10 updates on Humana that Becker's has reported since Oct. 30: 

1. Georgia will award Medicaid contracts to four Medicaid managed care organizations, including Humana.
2. Humana CFO Susan Diamond is stepping down after 18 years with the insurer. Celeste Mellet, the CFO of Global Infrastructure Partners, an investment fund, will be Humana's next CFO.
3. Humana misrepresented the providers its Medicare Advantage plans will be in-network with in 2025, Minnesota Attorney General Keith Ellison alleged.
4. Humana named Michelle O'Hara as chief human resources officer.
5. Cigna directly confirmed that it is not pursuing a merger with Humana.
6. [Click on the title's link to continue reading]

'A blessing': Hospital beds find new homes in families who had been praying for them 
Austin American-Statesman, Austin, TX; by Nicole Villalpando; 12/13/24 
Ron McDaniel had been trying to find a place for the hospital bed both his dad, Robert, and brother, Gary, had used in the assisted living facility where they were before they died. His father was a Navy veteran who was burned over 30% of his body during World War II. His brother had severe brain damage from a car accident in 1976 and was a quadriplegic. The electronic hospital bed with the extra comfortable mattress and the trapeze bar needed a new home. Ron McDaniel wanted it to go to a veteran or a veteran's family because it originally came from the Veterans Affairs, but he tried organization after organization with no luck. Meanwhile, Sandra Daniels was in desperate need of a hospital bed for her mother, Bertha Woodward, 87, who has heart failure, problems with her kidneys and limited mobility caused in part by neuropathy in her feet. Daniels could not afford a hospital bed but had been trying organization after organization for a year and came up empty. She had recently called AGE of Central Texas to see if they might have a hospital bed. ...
Editor's note: Organizations who helped include 26th Statesman Season for Caring, Austin Palliative Care, ATX Firefighter Moving, and AGE of Central Texas.

L.A.-area cyber attack could impact 17m patient records 
GT - Government Technology - Cybersecurity; by Scott Schwebke; 12/12/24 
Hackers claim they have retrieved 17 million patient records, including confidential personal and medical information, in a ransomware attack on PIH Health that has paralyzed operations at three hospitals, the Southern California News Group has learned. The Dec. 1 attack downed computer and most phone systems at PIH Health Downey Hospital, PIH Health Whittier Hospital and PIH Health Good Samaritan Hospital in Los Angeles. Also compromised were urgent care centers, doctors offices and a home health and hospice agency operated by PIH. PIH officials on Wednesday declined to comment on a threatening typewritten letter purportedly faxed by the cyber criminals late last week, saying they are working with a cyber forensic specialist and the FBI to untangle the ransomware attack. The FBI also declined to discuss the ongoing investigation.

15 most, least charitable states 
Becker's Hospital Review; by Andrew Cass; 12/6/24 
Wyoming is the most charitable state, with residents spending an average of 33 hours per year volunteering and donating nearly 4% of their adjusted gross income, according to WalletHub.   WalletHub analyzed the 50 states by comparing them across 17 key indicators of charitable behavior, such as the volunteer rate and share of income donated. ...
Most charitable: 1. Wyoming 2. Utah 3. Minnesota 4. Maine 5. Delaware 6. Maryland 7. Oregon 8. Colorado 9. Pennsylvania 10. Nebraska 11. Virginia 12. Illinois 13. New York 14. Iowa 15. North Dakota
Least charitable: 1. New Mexico 2. Arizona 3. Nevada 4. Rhode Island 5. Mississippi 6. Louisiana 7. West Virginia 8. Florida 9. Alabama 10. Hawaii 11. California 12. Oklahoma 13. South Carolina 14. Tennessee 15. Wisconsin

Why some healthcare unions are keeping strikes short 
Becker's Hospital Review; by Kristin Kuchno; 12/11/24 
One-day strikes and other "fixed-duration strikes" — defined as those with a short duration and predetermined time limits — are common at hospitals. While some healthcare unions have held longer or open-ended strikes, most have opted for shorter strikes in 2024. From 2021 to 2023, the majority of healthcare strikes were of a fixed duration rather than indefinite walkouts, ... Despite their brevity and predetermined endings, fixed-duration strikes still require health systems to activate contingency plans to ensure uninterrupted patient care. ... Even short strikes can have significant financial consequences for hospitals, particularly as costs for temporary staffing replacements rise, ...

University of Michigan Health-Sparrow nurses authorize strike as contract negotiations continue 
CBS News, Detroit, MI; by Elle Meyers; 12/12/24 
Union officials representing the University of Michigan Health-Sparrow nursing staff have been working for months for an improved contract, but leaders say they're not close to a deal. "The hospital so far is not making offers that are going to keep up competitive. It's not going to allow us to make sure we maintain our level of care or quality of care," said Jeff Breslin, a registered nurse and the president of the Professional Employees Council of Sparrow Hospital. The University of Michigan bought Sparrow last April. Bresil says he was hopeful for positive change. "They had promised to come in and build new facilities, improve other facilities that we have, which is great, but you've got to take care of the people as well, and frankly, I'm disappointed that this is the direction things are taking," he said. Breslin said contract negotiations between the nurse's union and the hospital began last August. Their contract expired in October, and they still haven't reached a deal. He says nurses want to see more competitive pay, better staffing levels and an improved health plan. 

New NIH-funded program will train ASU students for the future of AI-powered medicine 
Arizona State University - ASU News; by Richard Harth; 11/26/24 
The medical sector is increasingly exploring the use of artificial intelligence, or AI, to make health care more affordable and to improve patient outcomes, but new programs are needed to train engineers and biomedical researchers for this future. A team at Arizona State University has received a $2.35 million award from the National Institutes of Health (NIH) to establish just such a pioneering program to train doctoral students to meet these needs. The program will welcome its first cohort of PhD students in the spring of 2025.

One day you will tell your story of how you overcame what you went through and it will be someone else's survival guide. ~ Brene Brown