While the six-month home health and hospice moratorium, which is scheduled to end in mid-November, has been successful, it is not sustainable, according to Tom Koutsoumpas, founder and CEO of the National Partnership for Healthcare and Hospice Innovation (NPHI), a group of about 140 not-for-profit community-based programs located throughout the United States. This is why he is urging the Centers for Medicare & Medicaid Services to use a targeted approach in combating fraud in the sector. Still, while some of his members have had to put expansion plans on hold during this period, it has been worth it to get a handle on the problem, he told McKnight’s Home Care in a Newsmakers podcast.
A short-term home health and moratorium was a necessary action because of rampant fraud in the hospice sector, said Tom Koutsoumpas, founder and CEO of the National Partnership for Healthcare and Hospice Innovation (NPHI). Still, the moratorium, which is designed to contain and address egregious activities, is meant to be a short-term solution, said Koutsoumpas, who was involved when the benefit was created in the 1980s. There has been an overreaction during the moratorium, he noted, and acknowledged that some of his members have been subject to unnecessary audits. While the question of the moratorium has divided provider organizations, more imperative is that the community as a whole support and encourage the Centers for Medicare & Medicaid Services in their fraud-fighting efforts, he said. The organization’s support of the moratorium and may be one reason why NPHI has experienced a surge of new members of late. On another subject, he is excited about the attention palliative care has been receiving from CMS in rulemaking. NPHI has proposed a palliative care model that would be adjacent to the hospice benefit. More details are forthcoming, he said.
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Show contributors:
McKnight’s Home Care Editor Liza Berger; Tom Koutsoumpas, founder and CEO, National Partnership for Healthcare and Hospice Innovation (NPHI)