Funding for initiatives to support providers in all communities & care settings serving older adults remain central to advocacy & education efforts

WASHINGTON—LeadingAge president and CEO Katie Smith Sloan pushed back on criticism that opposition to the Center for Medicare and Medicaid Services (CMS) minimum staffing standards final rule has “no justifiable rationale” and allegations that greed is the basis of efforts to halt the rule’s implementation.

Following the $2 billion urinary catheter scam, CMS is attempting to crack down on ACO fraud

WASHINGTON—On June 28, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the proposed rule entitled, “Medicare Program: Mitigating the Impact of Significant, Anomalous, and Highly Suspect Billing Activity on Medicare Shared Savings Program Financial Calculations in Calendar Year 2023” (CMS-1799-P). 

Co-plaintiff status against Department of Health and Human Services is official

WASHINGTON—Following its early June decision to file to join the American Health Care Association’s (AHCA) lawsuit against the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS), LeadingAge, the association of nonprofit providers of aging services, including nursing homes, announced its official co-plaintiff status.

Rhode Island Legislature increases Medicaid rates above 75%

PROVIDENCE, Rhode Island—Rhode Island’s homecare providers are celebrating this evening’s passage of the state’s fiscal year 2025 (SFY25) budget set to begin on July 1, 2024. Within Article 9 of the budget, the Rhode Island General Assembly (state legislature) approved significant Medicaid fee-for-service rate increases for contracted homecare provider companies. These rate increases include some that are higher than 75% effective Oct. 1, 2024.


CMS rescinded the mplementation of the hospice certifying physician enrollment requirement due to already established law and regulation

WASHINGTON & ALEXANDRIA, Virginia—The National Association for Home Care & Hospice (NAHC) and the National Hospice and Palliative Care Organization (NHPCO) responded to the Centers for Medicare & Medicaid Services (CMS) recently revised guidance regarding the implementation of the hospice certifying physician enrollment requirement.

U.S. Senator Kevin Cramer is cosponsoring a Congressional Review Act resolution of disapproval against the final rule issued by CMS

WASHINGTON—The Centers for Medicare and Medicaid Services (CMS) announced a final rule in April, imposing minimum staffing requirements for long-term care facilities (LTC), which provide care to nearly

Julio Arsenio Rodriguez submitted millions in fraudulent claims to Medicare & Medicaid for medically unnecessary DME

MIAMI—A Miami federal district judge sentenced a fugitive to 87 months in prison followed by three years of supervised release for his role in a multimillion-dollar conspiracy to commit money laundering. The judge also ordered him to pay $3,709,860 in restitution.

Shiva Akula was convicted ton 23 counts in relation to an extensive health care fraud scheme

NEW ORLEANS—U.S. District Judge Lance Africk sentenced Shiva Akula, age 68, of New Orleans, to 240 months of imprisonment, three years of supervised release and $2,300 in mandatory special assessment fees, in relation to an extensive health care fraud scheme orchestrated by Akula. In November 2023, a federal jury convicted Akula of all 23 counts of his underlying indictment.

The bipartisan group demanded answers from CMS on the implementation of recent reforms aimed at combatting hospice fraud & abuse

WASHINGTON—On Wednesday, May 8, Congressman Earl Blumenauer (D-OR) and Congresswoman Beth Van Duyne (R-TX) led a bipartisan group of 38 lawmakers demanding answers from Centers for Medicare & Medicaid Services (CMS) on the implementation of recent reforms aimed at combatting hospice fraud and abuse.

The fee schedule payment rates for the PoNS Controller and Mouthpiece is to be discussed at the bi-annual HCPCS Public Meeting

NEWTOWN, Pennsylvania,—Helius Medical Technologies, Inc., a neurotech company focused on delivering a therapeutic neuromodulation approach for balance and gait deficits, announced that the Centers for Medicare & Medicaid Services (CMS) posted proposed Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedule payment rates for the PoNS Controller and Mouthpiece to be discussed at the bi-annual Healthcare Common Procedure Coding System (HCPCS) Public Mee


CGM suppliers who are recipients of the OIG requests have likely been notified via email

The American Association for Homecare (AAHomecare) reported that last week, the HHS Office of Inspector General (OIG) began sending emails and letters to a select group of continuous glucose monitor (CGM) suppliers as part of an evaluation for its study "Medicare Payments Compared to the Prices Available to Consumers and Suppliers for Continuous Glucose Monitors and Sensors." This study aims to determine the cost-effectiveness of Medicare payments in comparison to the supplier’s acquisition c

More have spoken on the rule which many believe will only add more pressure to already stressed staffing in home- and community-based care.

Since the Centers for Medicare & Medicaid Services (CMS) released its Final Rule on "Ensuring Access to Medicaid Services" on Monday, April 22, many in the industry have voiced their disappointment in the rule, including the National Association for Home Care & H

The organization said the Final Rule will result in agency closures, force providers to exit the Medicaid program and make access issues overall worse

WASHINGTON—The National Association for Home Care & Hospice (NAHC) released a statement noting that it was, 'extremely disappointed that the Centers for Medicare and Medicaid Services (CMS) elected to finalize the “payment adequacy” provision in the Medicaid Access Final Rule (CMS 2442-F).'

The proposed rule includes a 2.6% payment rate update, regulatory text changes and a proposed implementation of the Hospice Outcomes & Patient Evaluation (HOPE) tool.

WASHINGTON—On March 28, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1810-P) that would update Medicare hospice payments and the aggregate cap amount for fiscal year (FY) 2025 in accordance with existing statutory and regulatory requirements.


This implementation facilitates statewide aggregation of critical health care data aligned with the 21st Century Cures Act

VERLAND PARK, Kansas—Netsmart, a provider of software and services for payers, providers and state Medicaid Agencies, announced the deployment of the Netsmart electronic visit verification (EVV) system for the Montana Department of Public Health & Human Services (DPHHS). This implementation facilitates statewide aggregation of critical health care data aligned with the 21st Century Cures Act.

Findings reveal current audit process’ shortcomings

WASHINTON and ALEXANDRIA, Virginia—Following a series of meetings with the Centers for Medicare & Medicaid Services (CMS) and Members of Congress on efforts to improve and protect hospice program integrity, four national hospice organizations—LeadingAge, the National Association for Home Care & Hospice (NAHC), the National Hospice and Palliative Care Organization (NHPCO)