Literature Review
All posts tagged with “Regulatory News | Medicare.”
National trends in types of hospice disenrollment among older adults with dementia, 2012–2019
09/17/26 at 03:00 AMNational trends in types of hospice disenrollment among older adults with dementia, 2012–2019 Journal of the American Geriatrics Society; by Lauren J. Hunt, Siqi Gan, Krista L. Harrison, Melissa D. Aldridge, Claire Ankuda, W. John Boscardin, Alexandra K. Lee, and Alexander K. Smith; 9/15/26 Key Points
The critical competencies hospice leaders must build for value-based care success | part one
09/17/26 at 02:00 AMThe critical competencies hospice leaders must build for value-based care cuccess | part one Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Dr. Jessica Hubbs; 9/16/26 Value-based care isn’t just changing how hospice gets paid—it’s redefining what hospice leaders must be capable of delivering. In Part One of The Critical Competencies Hospice Leaders Must Build for Value-Based Care Success, host Chris Comeaux sits down with Dr. Jessica Hubbs, Chief Clinical Officer at Advanced Care Innovations, to explore the accelerating shift from fee-for-service healthcare toward models built around outcomes, total cost of care, and coordinated care delivery. Dr. Hubbs explains why emerging models such as LEAD (Long-term Enhanced ACO Design) matter to hospice and palliative care leaders—and why the movement upstream into serious illness and home-based care could represent both a competitive headwind and an extraordinary opportunity.
BPC’s comment on the CMS 2027 Physician Fee Schedule (PFS) proposed rule
09/16/26 at 03:00 AMBPC’s comment on the CMS 2027 Physician Fee Schedule (PFS) proposed ruleBipartisan Policy Center (BPC); by Zach Gaumer; 9/15/26 [Letter to Mehmet Oz, Administrator, CMS/HHS] This letter includes BPC’s comments on select provisions of CMS’s proposed rule. The enclosed comments focus on our recent work on Medicare Part B physician payment reform and primary care payment reform, digital technology and AI, complex and long-term care, and rural health care. We offer comments on the following provisions within the proposed rule:
Free webinar for physicians and healthcare professionals: Reducing hospital readmissions and length of stay in advanced illness patients
09/15/26 at 03:00 AMFree 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
Medicare moments: The scarcity of Medicare caregiver benefits
09/15/26 at 03:00 AMMedicare moments: The scarcity of Medicare caregiver benefits Allied News; by Joel Mekler; 9/14/26 ... AARP and the National Alliance for Caregiving released the 2025 Caregiving in the U.S. report, their newest update since 2020. This comprehensive document offers an in-depth look at the evolving landscape of family caregiving for adults, highlighting key trends, challenges, and potential reforms. A key discovery is the swift growth in family caregiving. Almost 25% of adults — 63 million Americans — spent the last year caring for an adult (59 million) or a child (4 million) with complex medical needs or disabilities, marking a 45% increase since 2015. This trend underscores the essential role of family caregivers and exposes systemic shortcomings that place significant burdens on them, highlighting the pressing need for reforms.
NPHI urges CMS to build on hospice moratoriam with targeted enforcement
09/15/26 at 02:00 AMNPHI urges CMS to build on hospice moratoriam with targeted enforcement Hospice News; by Jim Parker; 9/14/26 The U.S. Centers for Medicare & Medicaid Services (CMS) should follow the six-month moratoria on hospice and home health enrollment in Medicare with more pinpointed efforts to root out fraud, according to the National Partnership for Healthcare and Hospice Innovation (NPHI). The U.S. Centers for Medicare & Medicaid Services’ (CMS) implemented the moratoria in May. At the time, NPHI voiced support for the moratoria. The organization in March called for such action in a letter to CMS. Now, NPHI contends that the moratorium has “accomplished its intended purpose,” the nonprofit group said in a new letter to CMS Administrator Dr. Mehmet Oz and CMS COO Kim Brandt. The temporary moratoria is scheduled to expire in November.
CMS posts revised Model Election Statement and Addendum
09/11/26 at 03:00 AMCMS posts revised Model Election Statement and Addendum CMS; compiled by Guest Editor, Judi Lund Person; 9/10/26 CMS has posted the revised model election statement and addendum to the CMS website, which includes language for the mandatory addendum effective October 1, 2026. Hospice providers can use these model forms as the guide to the revised form. Pay particular attention to using the forms with an August 2026 date.
As home health moratorium nears expiration, advocates press CMS against extension
09/10/26 at 03:00 AMAs home health moratorium nears expiration, advocates press CMS against extension Home Health Care News; by MK Manoylov; 9/9/26 LeadingAge and the National Alliance for Care at Home (the Alliance) submitted new letters urging the Centers for Medicare & Medicaid Services (CMS) to allow the moratorium on Medicare home health enrollment to expire — even after LeadingAge has supported the freeze. These new letters also urge CMS to adopt more targeted enforcement measures to avoid implicating compliant providers.
Update to 2026 hospice payment rate correction
09/10/26 at 03:00 AMUpdate to 2026 hospice payment rate correctionFrom CMS; by Guest Editor Judi Lund Person; 9/9/26CMS has informed us on September 9, 2026 that there is a correction notice in clearance right now, which hopefully will be out soon. The change is minor and the wage index issue was across all payment systems, not just hospice.
Don’t let ‘bad actors’ sour the value of caring for California seniors at home
09/10/26 at 03:00 AMDon’t let ‘bad actors’ sour the value of caring for California seniors at home The Press-Enterprise; by John Fund; 9/8/26 We’re hearing a lot about fraud in federal programs lately. The new Ground Zero for fraud is in California, where a perfect storm of bad government has formed in the last few years. The worst cases involve Medicare and Medicaid. ... I’ve felt personal pain and anger over these types of scandals. A few years ago, my 87-year-old father in Sacramento mistakenly and prematurely went into hospice which meant Medicare payments for his ailments were foregone. ... Legitimate hospice remains important for people who actually need it. The fraud problem puts that care at risk.
CMS recalculating 2027 hospice payment rates due to error
09/09/26 at 03:00 AMCMS recalculating 2027 hospice payment rates due to errorHospice News; by Jim Parker; 9/8/26 The 2027 hospice payment rates likely will change based on a technical error by the U.S. Centers for Medicare & Medicaid Services (CMS). The agency made a mistake that affected the Fiscal Year 2027 hospice wage index and has recalculated those numbers. CMS is in the process of developing a correction notice to update the wage index and hospice payment rates for all four levels of care. This will not require another proposed rule.
LeadingAge, coalition partners tell CMS: don’t punish good Medicare providers
09/08/26 at 03:00 AMLeadingAge, coalition partners tell CMS: don’t punish good Medicare providers LeadingAge, Washington, DC; contact Colleen Knudsen; 8/31/26 In a joint sign-on letter led by LeadingAge, the association of nonprofit and mission-driven providers of aging services and submitted to the Centers for Medicare and Medicaid Services (CMS) today, a coalition of 19 partners representing hospitals, physician and clinician practices, post-acute and long-term care providers, home health and hospice agencies, suppliers, and the beneficiaries served by all, warn the agency that the proposed changes to Medicare provider enrollment provisions, included in the Calendar Year (CY) 2027 Home Health Prospective Payment System (PPS) Rule, risk penalizing legitimate providers and could result in limiting beneficiary access to care. The coalition fundamentally supports CMS’ responsibility to protect the Medicare Trust Fund and beneficiaries from fraud, waste, and abuse. However, ...
The hospice moratorium: what CMS is really signaling about the future | part two
09/08/26 at 12:00 AMThe hospice moratorium: what CMS is really signaling about the future | part one Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Dr. Jennifer Kennedy; 9/2/26 In Part One of this timely conversation, host Chris Comeaux and co-host Cordt Kassner, sit down with Dr. Jennifer Kennedy, Vice President for Quality, Standards and Compliance at CHAP, to unpack what the CMS hospice moratorium means, why it was implemented, and what hospice leaders should be watching next. Jennifer explains how escalating concerns around fraud and abuse, rapid market expansion, transactional hospice models, accreditation oversight, and Medicare enrollment have created an unprecedented regulatory environment. She also shares why she believes the moratorium could be extended as CMS continues strengthening enrollment screening and program-integrity efforts.
The Medicare Hospice Benefit's origins: Lessons on end-of-life caregiving
09/05/26 at 03:00 AMCMS oversight did not prevent Medicare Part D sponsors from making $587.7 million in ineligible payments to pharmacies for drugs available over the counter but labeled as prescription-only
09/04/26 at 03:00 AMCMS oversight did not prevent Medicare Part D sponsors from making $587.7 million in ineligible payments to pharmacies for drugs available over the counter but labeled as prescription-only United States Government HHS-OIG; Report number OAS-24-02-004; issued on 8/31/26, posted on 9/2/26
Mercy Hospice change in operator created conditions that posed ‘immediate jeopardy’ to patient well-being, state regulators say
09/03/26 at 03:15 AMMercy Hospice change in operator created conditions that posed ‘immediate jeopardy’ to patient well-being, state regulators say The Journal; by Jessie Bowman; 9/1/26 The ownership transition of Durango’s hospice program created serious problems in patient care and organizational oversight, according to state inspections that found multiple deficiencies and twice determined patients were at immediate risk of serious harm or death. In October 2025, the for-profit arm of the national CommonSpirit Health system – CommonSpirit Health at Home – took over ownership of the Mercy Hospice program. CommonSpirit assured the community the quality of care would not decline as a result of the transition. ... However, in May, the Colorado Department of Public Health and Environment conducted two concurrent relicensing inspections that found the ownership transition created system-wide deficiencies that led to clinical care practices and poor organizational oversight that put patient health and safety at serious risk.
Alzheimer’s blood test gets FDA clearance, but not CMS coverage
09/03/26 at 03:00 AMAlzheimer’s blood test gets FDA clearance, but not CMS coverage Inside Health Policy, Washington, DC; by Jessica Karins; 9/2/26 A blood test aiming to help with early identification of Alzheimer’s disease, including in primary care settings, by detecting buildup in the brain of the key Alzheimer’s biomarker amyloid beta plague, has been cleared by FDA, but the test and others in its category are not yet covered by CMS or any Medicare Administrative Contractors, its developer confirmed, with MACs having to make an individual determination for each patient of whether payment for the test is appropriate.
Hospice exclusion correction announced for the long-stay antipsychotic measure
09/03/26 at 03:00 AMHospice exclusion correction announced for the long-stay antipsychotic measure American Health Care Association (AHCA) and National Center for Assisted Living (NCAL); by Amy Miller; 9/1/26 The Centers for Medicare and Medicaid Services (CMS) has identified a subset of hospice residents who should have been excluded from the long-stay (LS) antipsychotic measure for the first quarter of 2026. These residents were inadvertently included because of incomplete hospice data in the CMS Centralized Data Repository. The issue affected approximately 2% of residents included in the measure for the quarter. CMS does not anticipate that it will significantly affect facilities’ overall measure results or quality measure ratings. CMS is updating its calculation to ensure that these residents are appropriately excluded going forward. The correction to first-quarter 2026 data will appear in the October 28, 2026, refresh of Nursing Home Care Compare.
Alliance submits comments in response to CY 2027 Home Health Proposed Rule
09/03/26 at 03:00 AMAlliance submits comments in response to CY 2027 Home Health Proposed Rule National Alliance for Care at Home, Alexandria, VA; Press Release; 9/1/26 The National Alliance for Care at Home (the Alliance) has submitted comments in response to the Centers for Medicare & Medicaid Services’ Calendar Year (CY) 2027 Home Health Prospective Payment System Rate and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program Updates proposed rule. The letter notes that the Alliance appreciates that, for the first time since CY 2022, CMS proposes a full annual payment update, does not propose to apply a new permanent adjustment, [and ...] However, the comment also emphasizes that these decisions do not undo the harm already built into the payment rate, nor do they do enough to protect access to care across the country.
The hospice moratorium: what CMS is really signaling about the future | part one
09/03/26 at 03:00 AMThe hospice moratorium: what CMS is really signaling about the future | part one Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Dr. Jennifer Kennedy; 9/2/26 In Part One of this timely conversation, host Chris Comeaux and co-host Cordt Kassner, sit down with Dr. Jennifer Kennedy, Vice President for Quality, Standards and Compliance at CHAP, to unpack what the CMS hospice moratorium means, why it was implemented, and what hospice leaders should be watching next. Jennifer explains how escalating concerns around fraud and abuse, rapid market expansion, transactional hospice models, accreditation oversight, and Medicare enrollment have created an unprecedented regulatory environment. She also shares why she believes the moratorium could be extended as CMS continues strengthening enrollment screening and program-integrity efforts.
2027 Final hospice rule could slow M&A
09/02/26 at 03:00 AM2027 Final hospice rule could slow M&A Hospice News; by Jim Parker; 8/31/26 Regulatory scrutiny is slowing down hospice M&A deals in 2026, and the recently approved 2027 final rule will be no hope. Interest in hospice acquisitions remains high, particularly among publicly traded companies and private equity firms. However, buyers are painstakingly combing through any potential compliance or billing issues during the diligence process, which is delaying closures, according to Mark Kulik, senior managing director of the M&A advisory firm The Braff Group.
CHAP: The Compliance Monitor 9/1/26
09/02/26 at 03:00 AMCHAP: The Compliance Monitor 9/1/26 Community Health Accreditation Partner (CHAP); 9/1/26August/September 2026 Compliance Activity:
AHA comments on CY 2027 Home Health proposed payment rule
09/01/26 at 03:00 AMAHA comments on CY 2027 Home Health proposed payment rule American Hospital Association; Press Release; 8/28/26 On behalf of our nearly 5,000 member hospitals, health systems and other healthcare organizations, including approximately 1,000 hospital-based home health (HH) agencies, our clinician partners — more than 270,000 affiliated physicians, 2 million nurses and other caregivers — and the 43,000 healthcare leaders who belong to our professional membership groups, ... The AHA has two significant concerns. First, CMS’ proposed payment update of 2.4% is inadequate. ... Second, the proposed rule includes substantial changes to Medicare provider enrollment authorities that would apply not only to HH agencies but also to all providers and suppliers enrolled in Medicare.
CMS says it has blocked or recovered more than $1.6 billion in suspect Medicare lab payments
09/01/26 at 03:00 AMCMS says it has blocked or recovered more than $1.6 billion in suspect Medicare lab payments VIN News, Washington, DC; by Reven Rosenfeld; 8/28/26 The Trump administration has blocked or clawed back more than $1.6 billion in potentially improper Medicare laboratory payments since President Donald Trump took office and removed 157 laboratory providers from the program over alleged billing fraud, officials with the Centers for Medicare & Medicaid Services said Friday.
Week ahead in health care: MedPAC meeting with in-person audience
09/01/26 at 02:00 AMWeek ahead in health care: MedPAC meeting with in-person audience Inside Health Policy; by Jessica Karins and Amy Lotven; 8/28/26 The Medicare Payment Advisory Commission (MedPAC) will meet Thursday (Sept. 3) and Friday (Sept. 4) virtually and, for the second time since the COVID-19 pandemic, with limited in-person public seating.
