The Centers for Medicare & Medicaid Services (CMS) recently stated in a newly released MedLearn Matter (MLN7867599, July 2023) that from July 13, 2021 onwards, any “new hospice agency” situated in the states of Texas, California, Arizona, and Nevada will be subjected to a “provisional period of enhanced oversight” for up to a year. The objective of this initiative is to drastically decrease or eliminate fraud, waste, and abuse.
Effectively impacting those in the hospice field, this measure extends up to a 12-month period, during which any new hospice agency in the aforementioned states will come under closer scrutiny. These enhanced surveillance measures are aimed at curbing malpractices and ensuring that resources are appropriately used.
Such intensified scrutiny marks a critical era of oversight for new hospices in these high-risk states associated with significant fraud, wastage, and abuse in the Medicare system. All professionals in the legal and healthcare sectors should be cognizant of these changes to ensure compliance with the updated CMS directives.
Those working within the CMS-regulated jurisdiction, particularly in the states of Texas, California, Arizona, and Nevada, are advised to remain alert to avoid penalties linked to non-compliance. It is crucial to analyze the operations and business practices of these hospice agencies to ensure adherence to the new regulations. Moreover, careful preparation and thorough understanding of the rules can potentially prevent cumbersome and costly legal disputes.
The CMS is making progressive strategic moves to secure the integrity of the Medicare system. This increased level of scrutiny towards new hospice agencies reflects a strategic shift in oversight and enforcement, presumably in an attempt to more effectively mitigate the occurrence of fraudulent activities.