The US Centers for Medicare & Medicaid Services (CMS) has implemented a final rule, striving for enhanced supervision of hospice providers across the United States. Primed to be effective from November 13, 2023, it aims to amplify the regulatory scrutiny on underperforming hospices via the Hospice Special Focus Program (SFP).
The ambit of this concluded rule oversees the Provider Enrollment and Oversight Tools that CMS utilizes for hospice providers. These serve as stringent measures for auditing, managing, and abating fraud, waste, and abuse in the health sector, especially among hospice care providers.
Fundamentally, the purpose of deploying such initiatives is to protect beneficiaries from subpar hospice care by improving the quality of Medicare-funded hospice services. It is anticipated that this will further promote patient safety, and ensure that hospices exhibit compliance in CMS’s health and safety standards.
The SFP, a pivotal component for balanced surveillance, is set to play a key role in regulating hospices that persistently defy CMS’s norms and conditions. It is expected to impose strict oversight and star-rate hospices based on continual performance evaluations. CMS might also deny Medicare payments to any hospices that fail to meet SFP standards, thereby encouraging compliance.
In light of this, legal professionals working within corporate healthcare settings must maintain acute awareness of these impending changes. It is imperative their organizations align with the CMS standards and practices to ensure the continued delivery of high-quality healthcare services. Failure to meet these expectations could result in significant financial losses, damage to reputation, and most importantly, risking the health and wellbeing of patients in hospice care.
For further information on the new CMS rule, please refer to JD Supra’s comprehensive report.