CMS: Nearly 400 Hospices Considered for ‘Administrative Action’ as Program Integrity Efforts Heat Up

Hospice News | By Jim Parker

The U.S. Centers for Medicare & Medicaid Services (CMS) is considering administrative action against 400 hospices, which could include revocation of their Medicare certification.

The agency has been mobilizing against hospice fraud this year. In addition to new regulations and updated survey processes, CMS has been conducting unannounced onsite visits. To date, CMS personnel have appeared at 7,000 locations, with plans to visit every hospice site in the country.

Two CMS officials outlined the effort in a blog post emailed to Hospice News — Dara Corrigan, CMS deputy administrator and director of the Center for Program Integrity, and Dr. Dora Hughes, acting director of the agency’s Center for Clinical Standards and Quality (CCSQ) and acting CMS chief medical officer.

“CMS revisited and revitalized our hospice program integrity strategy, focusing on identifying bad actors and addressing fraudulent activity to minimize impacts to beneficiaries in the Medicare program,” Corrigan and Hughes wrote. “As part of this strategy, CMS embarked on a nationwide hospice site visit project, making unannounced site visits to every Medicare-enrolled hospice. Our goal was to protect patients and their families from engaging with fraudulent actors by making sure that each hospice is operational at the address listed on their enrollment form.”

The agency is working to curb the impact of a rash of new providers that have emerged so far in four states: California, Arizona, Texas and Nevada…

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RSV Vaccine Approved for Use by Pregnant Women to Protect Newborns

KSL.com | By Lois Collins

WASHINGTON — For the first time, there's a vaccine for pregnant women to protect their babies against respiratory syncytial virus. The U.S. Food and Drug Administration this week approved Abrysvo for use at 32 to 36 weeks of gestation.

The vaccine, made by Pfizer, will protect infants from birth to up to 6 months of age from severe lower respiratory disease symptoms because of RSV, the agency said in announcing the approval, though the efficacy wanes to about 69% by 6 months.

"RSV is a common cause of illness in children and infants are among those at highest risk for severe disease, which can lead to hospitalization," said Dr. Peter Marks, director of the FDA Center for Biologics Evaluation and Research, in the news release. "This approval provides an option for health care providers and pregnant individuals to protect infants from this potentially life-threatening disease."…

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CDC and WHO Monitoring New COVID Variant with Large Number of Mutations

 NBC News | By Aria Bendix

Global disease experts are monitoring a new variant, BA.2.86, that carries a large number of mutations — meaning it looks significantly different from the original version of Omicron and the previously dominant strain targeted by upcoming Covid booster shots this fall.

It's still unclear how transmissible BA.2.86 is, though experts said it seems capable of sidestepping vaccine protection to some degree.

"We have not seen a new variant [in humans] with this many new spike mutations happening all at once since the emergence of the original Omicron,” said Jesse Bloom, an evolutionary biologist at Fred Hutch Cancer Center.

Mutations in the spike protein, one of three main parts of the SARS-CoV-2 virus, could make it easier for the virus to invade human cells.

So far, only a handful of cases of the new variant, BA.2.86, have been identified globally. In addition to one case in Michigan, the variant has also been spotted in Denmark, Israel, and the UK, according to sequences uploaded to GISAID, a global virus database…

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The Upheaval at America’s Disappearing Nursing Homes, in Charts

The Wall Street Journal | By Jon Kamp, Melanie Evans, and Gretchen Lenth

America’s nursing homes are fading away.

The U.S. has at least 600 fewer nursing homes than it did six years ago, according to a Wall Street Journal analysis of federal data. More senior care is happening at home, and the Covid-19 pandemic caused many families to shun nursing homes while draining workers from an already short-staffed industry.

The result? Frail elderly patients are stuck in hospitals, a dangerous place for seniors, waiting for somewhere to go—sometimes for months. Beds are disappearing while the need for senior care is growing. The American population 65 and older is expected to swell from 56 million in 2020 to 81 million by 2040.

Even before the industry started to shrink noticeably, it was effectively contracting. Though fewer people tend to live in counties without nursing homes, those counties tend to have more elderly residents than average. For people who need comprehensive care, closures can mean disruptive moves or ending up far from loved ones.

Data show capacity in the nursing-home industry has lagged behind growth in the ranks of older Americans for many years. By 2018, the decline accelerated as nursing-home beds steadily disappeared.

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