Literature Review

CMS COO: Moratorium has blocked 250 home health agencies from Medicare enrollment Home Health Care News; by Morgan Gonzales; 10/29/26The moratorium on Medicare home health enrollment has blocked 250 agencies that applied from gaining approval, according to Kim Brandt, the deputy administrator and chief operating officer of the Centers for Medicare & Medicaid Services (CMS). The moratorium on hospice enrollment, meanwhile, has blocked 50 hospices from enrolling, she added, saying that she was surprised at the proportion of home health versus hospice enrollment attempts. 

Patients with suboptimal discharges – a follow-up (and rescinding hospice billing)RACmonitor; by Ronald Hirsch, MD, FACP, ACPA-C, CHCQM, CHRI; 10//28/26 Let me start with an update on my project to get a way to indicate on a hospital claim that a patient has discharged to a less-than-optimal location. ... [That began] with a push to use the “against medical advice” designation for such patients. But the stigma behind that term led me to adopt the suggestion of Valerie Rinkle, a nationally known revenue integrity expert, who proposed adoption of a condition code instead of using a discharge status code. Last week I once again presented to the National Uniform Billing Committee (NUBC), asking for such a code to be established. During that meeting, one of the members came up with an even better idea: establishing two condition codes, one for when the patient chooses a less-than-optimal location, and a different condition code for when the payer refuses to approve the suggested post-acute care.

CMS COO: hospice, home health moratoria a successful approach Hospice News; by Jim Parker; 10/29/26 The U.S. Centers for Medicare & Medicaid Services’ (CMS) temporary moratoria on hospice and home health provider enrollment in Medicare has been working, according to Kimberly Brandt, the agency’s deputy administrator and COO. To date, during the six-month enrollment freeze, CMS has denied 50 hospice and 250 home health applications. Also, CMS has seen “huge drops” in billing, particularly in geographic areas known to be rife with fraud. This includes states like California, Texas, Nevada, Ohio, Georgia and Arizona.

HHS drops expired 2025 Alzheimer's treatment goal in new dementia plan focused on prevention and early detection Medical Daily; by Cole Mercer; 10/27/26 The federal government has rewritten its national dementia strategy, shifting the focus toward prevention and earlier detection. HHS Secretary Robert F. Kennedy Jr. announced the updated national plan on Alzheimer's and related dementias on Oct. 22 at Broward Health Medical Center in Fort Lauderdale, Florida. The new plan replaces six long-standing goals with four. ...

Free webinar for physicians and healthcare professionals: Reducing hospital readmissions and reducing Hospital Readmissions and Length of stay in advanced illness patients VITAS Healthcare; Press Release; 9/14/26

CMS and states launch $275 million initiative to recruit and retain nurses in nursing homes CMS Newsroom; Press Release; 10/23/26 The new Nurses for Nursing Homes initiative is expected to support more than 4,000 nurses and nursing students nationwide, including those serving rural communities. Nursing students and licensed nurses interested in working in a nursing home may now qualify for up to $40,000 in student loan repayment and/or a $10,000 stipend in exchange for a three-year commitment to serve in a qualifying nursing home in a rural or higher labor-shortage area through a new $275 million nationwide initiative announced today by the Centers for Medicare & Medicaid Services (CMS). 

Feds hold back an additional $1.2 billion in California Medicaid reimbursements ArcaMax; by Ana Ceballos, Los Angeles Times; 10/20/26 The Trump administration is deferring an additional $1.2 billion in Medicaid reimbursements to California, citing concerns about potential fraud in a state program that helps older adults and people with disabilities with everyday tasks. Dr. Mehmet Oz, the administrator for the Centers for Medicare and Medicaid Services, said federal officials took action after they grew concerned about the rapid expansion of California's personal care services program in recent years. State officials were notified of the decision Tuesday, he said.

Home health and hospice personnel file audit checklist for ACHC, CHAP and Joint Commission Surveys (2026) Corvara HR; 10/15/26 When ACHC, CHAP or The Joint Commission surveys a Medicare-certified home health agency or hospice for deemed status, the federal Conditions of Participation are the floor. This checklist turns the personnel parts of those rules into a file-by-file audit, adds the OSHA and Form I-9 records every file needs, marks what each accreditor publishes on top, and shows how to run the audit before a surveyor does.

Hospice election addendum: Now mandatory! Tools and grace!Provider Insights; by Annette Lee; 10/6/26This week, the Election Addendum became mandatory for all new hospice elections beginning October 1st, 2026. Thankfully, due to significant advocacy, CMS also announced this week that they will provide "enforcement discretion" for quarter one and have ensured the MACs will not deny solely on this new requirement. Hospices should use this time of grace to ensure they have full compliance with this new condition of payment. [Please see article for CMS announcement and presentation, an audit tool, and discussion.]

Hospice medical review top denial reason codes Q2 2026Palmetto GBA; 8/28/26Hospice Medical Review Top Denial Reason Codes: April to June 2026. We encourage all providers to review this information when filing claims to prevent denials and to ensure their claims are processed timely. The following information affects providers billing 81X bill types. Top five denial reasons include [see article for entire list]:

Value-based care and alternative payment models: What they are and how they workHealthcare Financial Management Association (HFMA); by HFMA; 9/20/26Value-based care (VBC) is an approach to healthcare that seeks to improve the quality, outcomes and experience of care while managing its cost. Rather than rewarding healthcare organizations solely for the volume of services they provide, value-based arrangements link some or all payment to measures of quality, outcomes, utilization or total cost of care.

The home health and hospice moratorium at six months: what CMS’ anti-fraud CRUSH initiative has meant for providers JD Supra; by Lanchi Nguyen Bombalier; 10/1/26 Key Takeaways

How CMS’ proposed rule would build palliative care into the home health system Home Health Care News; by Morgan Gonzales; 9/30/26 The U.S. Centers for Medicare & Medicaid Services’ (CMS) proposal to add palliative care as a billable service under the Medicare Home Health Benefit could expand home health agencies to develop relationships with different types of providers. However, adding palliative care as a billable service could also make it difficult for home health providers to provide palliative services as robust as those delivered through the hospice benefit. Home health providers have celebrated the inclusion of palliative care in CMS’ proposed CY2027 home health payment rule. ... The rule will not change eligibility requirements for the home health care benefit. To qualify, a patient must: ...