[813594]

Do you have any figures to back this statement up? When you say dumping do you mean transferring? Discharging? Revocations? Those events are, and should be, looked at with great scrutiny in compliance surveys.

Home Health Agencies are not the same as Hospice agencies (the article seems to use the terms interchangeably). As far as I'm concerned, nonprofit/for profit in hospice is really just tax status. All Medicare certified hospices agencies follow the same guidelines, bill the same payor, and are paid the same rate. The Medicare Conditions of Participation say you must take patients regardless of their ability to pay (you can't just try, all providers must and it's why you see it printed on their brochures).

Hospice is a service business and differences are found in quality of care.

As for Medicaid, I really only know about Arizona. Since at least 2001 Arizona has approved hospice care for Medicaid (AHCCCS) patients in hospice and in July 2009 started stalling on payment. In January 2010 they made the decision to retroactively eliminate Hospice services as of July 2009. All Hospice providers who cared for patients July 2009-Jan 2010 were now told the accounts would not be paid. This has lead to some providers avoiding contracting with AHCCCS and thus impacted AHCCS patients access to care when they don't qualify for the Medicare benefit. Of course the patients can still contact any local Medicare hospice and seek charity care regardless of their ability to pay.