Home Health & Hospice

Wasteful and Inappropriate Service Reduction (WISeR) Model - Liles Parker

Update on the Medicare Hospice PPEO Audit Initiative and its Risks

Home Health & Hospice /

(November 3, 2025): During 2024 and 2025, hospice agencies have remained under the government’s enforcement microscope. One survey found that more than one-half of all Medicare hospices reported undergoing more than one audit at the same time. These audits have led to substantial administrative burdens and payment delays.[1] Over the past year, our attorneys have represented […]

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Agencies Around the Country are Facing Expanded Administrative Medicare Hospice Audits and Investigations - Liles Parker

Agencies Around the Country are Facing Expanded Administrative Medicare Hospice Audits and Investigations

Home Health & Hospice /

(November 5, 2024): It’s been a frustrating year for many Medicare hospice providers around the country. Throughout 2024, hospice agencies have been under the focused scrutiny of both program integrity[1] and administrative claims processing[2] contractors working for the Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS). Unfortunately, the government’s

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Hospice Audit and Investigative Actions are Expected to Rise in 2024 - November 2023

Hospice Audit and Investigative Actions are Expected to Rise in 2024

Featured, Home Health & Hospice /

(November 20, 2023): Medicare, Medicaid, and most private insurance plans cover hospice care and related services. To be eligible for hospice care,[1] a patient must be certified as terminally ill and have a life expectancy of six months or less.  In recent years, the hospice industry has exponentially grown, and the number of Federal, State

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VA Acupuncture Audits of Non-VA, Community Providers are Increasing

Home Health & Hospice, Other /

(May 20, 2022): Acupuncture audits and investigations by federal, state and private payors have greatly expanded in recent years. One of the most active players conducting acupuncture audits today is the U.S. Department of Veterans Affairs. (VA). It is worth noting that long before traditional Medicare even considered covering acupuncture services,[1] the VA made these

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State and Federal Hospice Audit and Investigation Efforts are Expanding in 2022

Home Health & Hospice /

(May 12, 2022): Hospice agencies are again the focus of both state and federal investigators and prosecutors around the country. The number of hospice audits and investigations at both the state and federal levels have risen in 2022. This isn’t surprising given the ever-expanding level of beneficiary participation and cost of Medicare’s hospice benefit program.

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Home Health Revocation Actions by Medicare are Expanding Around the Country

Home Health & Hospice /

(September 28, 2020):Last September, CMS published a Final Rule titled “Medicare, Medicaid, and Children’s Health Insurance Programs; Program Integrity Enhancements to the Provider Enrollment Process.” [1] Among its many chan ges, the Final Rule significantly expanded the reasons that may be asserted by the Centers for Medicare and Medicaid Services (CMS) when revoking a health

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Recent Developments in Personal Care & Community-Based Services in Medicaid and Medicare

Home Health & Hospice /

(March 23, 2020): Until recently, personal care services, such as home health aides, were not covered under the Medicare program unless they were part of a skilled service where the beneficiary was homebound.  However, beginning with calendar year 2019, the Medicare program has expanded the ability of plans that participate in the Medicare Advantage program

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OIG Has Identified Common Errors by High-Risk Home Health Agencies.  Does Your Home Health Agency Have These Documentation Problems?

Home Health & Hospice /

(September 30, 2019): On September 5, 2019, the Department of Health & Human Services (HHS), Office of Inspector General (OIG) published an HHS-OIG Data Brief entitled “The Centers for Medicare & Medicaid Services Could Use Comprehensive Error Rate Testing Data To Identify High-Risk Home Health Agencies”[1] The purpose of OIG’s review was two-fold: First, OIG

OIG Has Identified Common Errors by High-Risk Home Health Agencies.  Does Your Home Health Agency Have These Documentation Problems? Read More »

Home Health Agency Alert: The Review Choice Demonstration Project start dates for Ohio, Texas, North Carolina and Florida are Around the Corner!

Home Health & Hospice /

(August 7, 2019): This article further updates our articles of February 19th and April 9th on the announcement by CMS of the implementation of the new five year “Review Choice Demonstration Project’ in five states – Illinois, Ohio, Texas, North Carolina and Florida, and the start date for the Demonstration Project in Illinois. I. Background

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Home Health Agency Alert: The Review Choice Demonstration Project is Moving Forward in Illinois Effective June 1, 2019

Home Health & Hospice /

(April 9, 2019): This article updates our article of February 19 on the lifting by the Centers for Medicare and Medicaid Services (“CMS”) of the moratorium on the enrollment of new home health agencies in Florida, Illinois, Michigan and Texas, and the announcement by CMS of the implementation of a new five year “Review Choice

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