25 Comments
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Tracey Sulzberger's avatar

Is there any evidence that they are doing this to hospices in states not in the moratorium?

Jim Parker's avatar

The CMS moratorium is national, though a couple of states have their own related to licensure, specifically California and Nevada.

Tracey Sulzberger's avatar

Yes I just wasn't sure if the payment suspension you wrote about related to live discharges was national just for those 8-9 states under current review. Thanks for responding!

Jim Parker's avatar

My understanding is that CMS can suspend payments for any hospice that has been found to have certain compliance issues. However, the vast majority of the recent suspensions have been concentrated in certain markets such as LA County, Nevada, other parts of California.

Tracey Sulzberger's avatar

Yes I was just curious about the recent suspensions and their relevance to the 6-8 states. Thank you!

Jerry Soucy's avatar

"Some are even going out of business as a result."

Objection - stated as fact without evidence

Nena Hart's avatar

Jerry, I'm a compliance consultant, and this is 100% true. I have two current clients closing because of this. Neither in California nor guilty of committing known/rampant fraud. It is absolutely happening.

Jerry Soucy's avatar

More info and context would help a reader understand - for example, do either / both operate to generate a financial return that satisfies owners / investors? did either / both have weak balance sheets?

Finally, "known/rampant" is doing all of the heavy lifting

Hospice fraud started with the Medicare hospice benefit, when somebody figured out you could make money in hospice

That now describes 80%+ of the "industry"

This didn't happen overnight or in the dark

It's been developing for over 40 years and especially the last 25 in broad daylight while everyone watched

Jim Parker's avatar

I have confirmation from six sources on this.

Jerry Soucy's avatar

More details would be helpful - otherwise it's just jazz hands

Jerry Soucy's avatar

Yes, right - thanks Jim

I read it when it came out and forgot you talked to Edo

I certainly remember this: "I would say, every day since [April] 21, I’ve heard at least two to three companies closing their doors and trying to transfer their patients out to other hospices.”

If we do the math based on it holding true through today, over one hundred (100!) hospices have closed since April 21?

Across the country? Just in California? Just at one address?

Let's say it was 20 days when you spoke, that's still 40-60 hospices? Really?

Anyway, that's the kind of stuff that leads me to side-eye, use salt, etc

Beth Noyce's avatar

Mentioning the names of the hospices would be unethical here.

Jerry Soucy's avatar

Well, info provided on background is fine, but Jim's a reporter so I'm sure he understands the value of finding people willing to go on the record, it really helps readers understand issues, context and most importantly establishes credibility

They're out there, it just takes digging

I think the problem here is that hospice news is an industry newsletter, not an independent news reporting publication

Jim Parker's avatar

I assure you, Jerry, the fact that we cover hospice and palliative care exclusively in no way compromises our independence or our integrity.

Jerry Soucy's avatar

Hi Jim - I see what you did over there 😎

These are important issues, I'm committed to patients and families facing serious illness and end of life, through death care and final disposition to bereavement, memorialization and legacy, and it's annoying to see that trajectory financialized like fast food, and spoken of in those same terms by the same snakes in suits but that's where we are - hospice has been captured and corrupted

Thanks, Jerry

Jerry Soucy's avatar

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Jim Parker's avatar

We dig and we dig and we dig, Buy at some point, we just have to call it and write the story, and we're not going to turn away a credible source because they don't wish to be named.

Jerry Soucy's avatar

You're the editor 🤷‍♂️

Beth Noyce's avatar

More examples are available in California, where the epicenter of all this began.

Jerry Soucy's avatar

Objection, vague nonresponsive

Beth Noyce's avatar

Jerry, do you have sources confirming this is NOT happening? I'd like to know about those sources, as it is not what I see day-to-day in my work.

Jerry Soucy's avatar

What I know is lots of vague stories from "the industry" but not much detail beyond "500 hospices with the same PO Box!! Near a taco stand!!! In California!!!!"

What I also know is that fraud only makes sense to me if what you're mostly trying to make money in the first place

Fraud in hospice started with the Medicare hospice benefit, when somebody figured out you could make money in this business

It's been on the rise ever since

It's ubiquitous