Hospice provider wins injunction against HHS efforts to enforce 'capricious' reimbursement cap

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Frontline, ProPublica slam assisted living sector in documentary airing tonight
Frontline, ProPublica slam assisted living sector in documentary airing tonight

An Arkansas hospice provider has been granted a temporary reprieve from efforts by the Department of Health and Human Services to recoup reimbursement the federal agency says exceeds the annual Medicare reimbursement cap for hospice services.

The U.S. District Court for the Eastern District of Arkansas, Western Division, stopped HHS' efforts to collect the money on Aug 17. The court ruled that the provider, Southeast Arkansas Hospice Inc. (SEARK), would suffer “irreparable harm” if HHS withheld further payments to the hospice firm. The court also noted that a number of U.S. district courts across the country have ruled against the Medicare hospice reimbursement cap, calling it arbitrary and capricious.

SEARK had been told it had exceeded the Medicare hospice cap by hundreds of thousands of dollars over the previous few years, according to a Bureau of National Affairs report. HHS attempted to cut off all future payments in order to recoup the alleged overpayments. The court issued a 14-day restraining order against HHS with a possibility of “an extension by the court for good cause.”