Literature Review

Man pleads guilty in connection with $17m Medicare hospice fraud and home health care fraud schemes Office of Public Affairs - U.S. Department of Justice; Press Release; 2/3/25A California man pleaded guilty today to health care fraud, aggravated identity theft, and money laundering in connection with a years-long scheme to defraud Medicare of more than $17 million through sham hospice companies and his home health care company. According to court documents, Petros Fichidzhyan, 43, of Granada Hills, engaged in a scheme with others to operate a series of sham hospice companies. Fichidzhyan, along with co-schemers, impersonated the identities of foreign nationals to use as the purported owners of the hospices — including using the identities to open bank accounts and sign property leases — and submitted false and fraudulent claims to Medicare for hospice services that were not medically necessary and not provided. In submitting the false claims, Fichidzhyan and his co-schemers also misappropriated the identifying information of doctors ... [Click on the title's link to continue reading.]

New report details hospice industry outlook for 2025 PR Newswire, Cleveland, OH; by WTWH Media; 1/30/25 Hospice News, a WTWH Media publication, is pleased to announce the results of its annual outlook survey on the state of the hospice and palliative care markets. Conducted in collaboration with home-based care EHR leader Homecare Homebase, the survey compiles the views of more than 100 industry professionals to uncover the key factors defining the hospice landscape in 2025. Responses come from a range of provider representatives, including owners, operators, C-suite executives, managers and staff. In summary, respondents indicated:

The Handbook of LGBTQIA-inclusive Hospice and Palliative Care, 2nd edition Review in Ageing & Society, published online by Cambridge University Press; book authored by Kimberly D. Acquavia, review authored by Luis Stoisser; 1/23/25 The Handbook of LGBTQIA-inclusive Hospice and Palliative Care is a comprehensive guide to providing inclusive palliative and hospice care to everyone, regardless of their self-identification. Following the author's belief that LGBTQIA+ hospice and palliative care requires change at three levels - individual, institutional and systemic - the book extends state-of-the-art palliative and hospice practices (US focused) by including LGBTQIA+ perspectives. Such a rethinking educates hospice and palliative care practitioners on how to provide person-centered care, how to be self-reflexive on a daily basis and how to handle their own stereotypes and stigmas. [This book is available via Columbia University Press and Amazon.]

Cyber Threats 2025 Teleios Collaborative Network (TCN); by Joel Garr; 1/28/25One of the biggest worries hospices face today is the threat of a cyberattack. ... Experts say there are four steps to developing the plan.

The iatrogenic consequences of medicalising grief: Resetting the research agenda Sociology of Health & Illness: by Sarah Gurley-Green, Lisa Cosgrove, Milutin Kostic, Lauren Koa, and Susan McPherson; published 11/28/25, distributed via Evermore 1/28/25When the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013, there was a firestorm of controversy about the elimination of the bereavement exclusion. Proponents of this change and of the proposed “complicated grief” designation believed that this change would help clinicians recognise major depression in the context of recent bereavement. Other researchers and clinicians have raised concerns about medicalising grief. In 2022 “prolonged grief disorder” (PGD) was officially included in the DSM-5-TR in the trauma- and stressor-related disorders section. ... As human rights activists have argued, bereavement support is an inalienable human right, one that is centered on the right to health and well-being, for “bereavement health is as intrinsic to our humanity as any other aspect of health and citizenship” (Macaskill 2022). That is why there are increasing calls for investing in bereavement as a public good and for “cultivat[ing] a bereavement-conscious workforce.” (Lichtenthal et al. 2024, e273). As Lichtenthal notes, it is not only clinicians but also institutions and systems that must “shift bereavement care from an afterthought to a public health priority.”Editor's note: "Iatrogenic" refers to unintentional consequences/condition from a medical intervention. In the hospice context, this means bereavement/grief from the hospice death. How many patients do you serve? The CMS Hospice Conditions of Participation identify "bereavement" and/or "grief" 155 times. What priority do you give to bereavement care before, at and after your patients' deaths?

Michigan Center for Rural Health working to expand rural palliative care Hospice News; by Jim Parker; 1/29/25Recent studies have established a dire need for palliative care in rural areas, and the state of Michigan is no stranger to this situation. To respond to the need, the Michigan Center for Rural Health (MCRH) is partnering with Stratis Health, a nonprofit consulting firm that specializes in assisting rural communities with providing palliative care services. The two organizations, which have partnered on projects related to critical care hospitals and Medicare beneficiaries, will choose five rural communities in the state with the goal of increasing their capacity to provide palliative care. In the current phase of the project, Stratis will be training MCRH staff to apply their framework for implementing palliative care programs in the target areas.

DEA proposed telemedicine prescribing rule could burden hospice physicians and hospice operations Morgan Lewis, Washington, DC; by Howard J. Young, Jacob J. Harper, and Roshni Edalur; 1/27/25 Signaling a possible future approach to regulating Schedule II-V prescribing via telemedicine in lieu of in-person examinations, on January 17 the DEA issued a notice of proposed rulemaking regarding its next iteration of controlled substance prescribing controls. With comments due March 18, 2025, the Proposed Rule is not subject to the Trump administration’s executive order freeze on new proposed regulations. [Click on the title's link to continue reading.]

Former hospice physician alleges retaliation against nonprofit healthcare provider Northern California Record; by Northern California Record State Court; 1/23/25 In a gripping legal battle that raises questions about medical ethics and employee rights, a former hospice physician has filed a lawsuit against his previous employer, alleging wrongful termination and retaliation. The complaint was lodged by Kamaldip Ghei in the Superior Court of California, County of San Francisco, on January 10, 2025, targeting Sutter Visiting Nurse Association and Hospice dba Sutter Care at Home. ... Ghei claims he was wrongfully terminated after raising concerns about the organization's practices regarding patient care. Specifically, he alleges that he was pressured to keep patients in hospice care even when it was not medically justified. ...

Why drug prices & modern tech matter in hospice care, too, with Nick Opalich Capital Rx; podcast with Nick Opalich; 1/24/25 For Episode 51 of the Astonishing Healthcare podcast, we spoke with Nick Opalich, CEO of HospiceChoice Rx. We learned about how end-of-life care is evolving in the U.S., including the roles pharmacy and technology play in the hospice industry. Nick discusses some similarities between the hospice pharmacy benefit management (PBM) and commercial PBM spaces, such as the importance of a great pharmacy network and independent pharmacies, why the drug price index matters (NADAC vs. AWP), medication access, and disconnected systems. A former pharmacy owner himself, Nick explains the importance of helping hospice providers control drug spend, which is usually the second highest cost behind labor, and reimbursement trends/pressure. 

AHHC joins other state hospice advocates in legal challenge to Special Focus Program The Association for Home and Hospice Care of North Carolina (AHHCNC); Press Release; 1/23/25The Association for Home and Hospice Care of North Carolina (AHHCNC) has joined a multi-state coalition of hospices and hospice associations in challenging the federal government's implementation of the Hospice Special Focus Program (SFP), deeming it unlawful and arbitrary. The challengers are seeking a preliminary injunction to halt the SFP, citing patient safety concerns, misrepresentation of compliance records, and jeopardized access to high-quality end-of-life care. Congress directed CMS to establish the SFP to enhance enforcement for noncompliance hospices, but the Final Rule includes unrelated measures, heavily relying on survey data and other information not related to hospices’ compliance with Medicare requirements. Tim Rogers, President and CEO of AHHCNC, states:  "The approach CMS uses disadvantages well-established hospices and ignores Congress’s intent." [Click on the title's link to continue reading.] 

Healthcare Industry Team 2024 Year in Review JD Supra; by Claire Bass, S. Derek Bauer, Kevin Bradberry, Ernessa Brawley, Sarah Browning, Charlotte Combre, Payal Cramer, Emily Crosby, Vimala Devassy, Shareef Farag, Amy Fouts, Winston Kirton, Caroline Landt, Charlene McGinty, Justin Murphy, Lynn Sessions, Gregory Tanner; 1/22/25As we begin a year that will once again be transformative for the industry, we are excited to present our comprehensive 2024 year-in-review, highlighting all that has happened and the trends that will shape 2025. [Downloadable PDF from BakerHostetler, bakerlaw.com. Large categories include the following:]

CEOs face personal inflection point affecting decision making, management and culture; seek to recalculate AI journey, CEO study finds GlobeNewswire - The Futurum Group; media contact, Nati Katz; 1/21/25 Global Management Consulting Partnership Kearney, and Futurum, the leading research, intelligence and advisory firm, today jointly announced the release of the 2025 CEO AI Management study. As largest of its kind for CEO response rates within the company size targeted, the published global CEO Study examined leadership’s stance and status of organizational AI adoption, implementation and roadmaps, – revealing alarming backlash effects that CEOs may already experience. ... Futurum and Kearney managed to develop a substantial CEO playbook for AI which features five points that lead to breakthroughs in AI outcomes. [Key items from their "Five-Point CEO Playbook" include:]

US dementia cases projected to double within 40 years Medscape Medical News; by Pauline Anderson; 1/13/25 The number of US adults who will develop dementia each year is projected to increase from approximately 514,000 in 2020 to about 1 million in 2060, new research shows. In addition, the lifetime risk of developing dementia after age 55 is estimated at 42%. The research showed that the relative growth in dementia cases is particularly pronounced for Black adults. These new findings researchers say, “highlight the urgent need for policies that enhance healthy aging, with a focus on health equity.”