Haven Hospice Gets Medicare to Return Money from Cap Payment ~ Pallimed: A Hospice and Palliative Medicine Blog

Monday, August 31, 2009

The National Alliance for Hospice Access has issued a press release stating the Department of Health and Human Services/ Center for Medicare Services has been ordered by a California Judge to repay with interest the Hospice Cap Overpayment to the Los Angeles area Haven Hospice.

You can read the Judge's summary order here and the NAHA press release here. The NAHA notes the California judge has also barred HHS from using the current cap calculation to reclaim overpayment to hospices. It is not mentioned in the judge's summary order (or I can't read legal-ese) but this is likely to be either just in California or challenged at a federal level I would think. I imagine the NAHA and any member hospices who have had to pay Hospice Cap overpayments will bring this argument to other states.

The NHPCO has made no formal statements on the recent Haven Hospice ruling nor does any of the NHPCO's current legislation reform effort include the NAHA supported legislation recently introduced to re-tool the Medicare Hospice Cap. There is also no mention of the actual monetary amount to be repaid, but from some numbers hospice cap overpayments average $1milllion.

Dave Daucher said... September 02, 2009 Thanks for the continuing even-handed discussion and coverage of the hospice cap crisis. One clarification to your post: the Los Angeles Federal District Court's ruling in the Haven Hospice case clearly enjoins HHS prospectively and nationally from using the invalid regulation as the basis for any cap repayment demand on any hospice. While HHS may choose to appeal, it seems clear that, as of the Court's ruling, the invalid regulation has been set aside and may not be used to calculate cap demands for any hospice.
Dave Daucher said... March 27, 2011 Thanks for the continuing even-handed discussion and coverage of the hospice cap crisis. One clarification to your post: the Los Angeles Federal District Court's ruling in the Haven Hospice case clearly enjoins HHS prospectively and nationally from using the invalid regulation as the basis for any cap repayment demand on any hospice. While HHS may choose to appeal, it seems clear that, as of the Court's ruling, the invalid regulation has been set aside and may not be used to calculate cap demands for any hospice.