Hospice Insights: The Law and Beyond

The United States Supreme Court recently overruled decades-old precedent that favored an administrative agency’s interpretation of ambiguous statutes. This seismic shift in the role of the judiciary will affect every regulated industry, including healthcare and hospice in particular. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki discuss the implications of this decision in the...

Hospices that have been audited have to decide how to address any alleged overpayment identified by the auditor, whether through a voluntary repayment, recoupment, or applying for an extended repayment schedule. CMS recently identified updates to the Medicare Financial Management Manual relating to these options. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki discuss those updat...

In this episode, Husch Blackwell’s Meg Pekarske is joined by long-time hospice friend and industry guru Greg Grabowski. They turned the microphone on their usually private (but always lively) discussions on what’s going on in the wide world of hospice. To make it especially fun, they each prepared, but did not share prior to recording, their own list of what’s working and not working in hospice ri...

UPIC activity is picking up, and the UPICs are reviving some old tactics. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki continue the discussion on these trends which include extrapolation, Medicaid nursing home room and board payments, patient interviews, and more. Meg and Bryan also describe some handouts they’ve developed to help hospices stay prepared for the inevitable audi...

UPIC activity is picking up, and the UPICs are reviving some old tactics. In this episode, Husch Blackwell's  Meg Pekarske and  Bryan Nowicki discuss these trends which include extrapolation, Medicaid nursing home room and board payments, patient interviews, and more. Meg and Bryan also describe some handouts they’ve developed to help hospices stay prepared for the inevitable audit.

A strong and engaged Chief Medical Officer (CMO) may be a hospice CEO’s most important asset. But what does a successful CEO/CMO relationship look like and how must it evolve to meet today’s challenges? In this episode we get to find out, as Husch Blackwell’s Meg Pekarske is joined by HopeHealth CEO Diana Franchitto and Dr. Edward Martin, CMO, whose trusted relationship has been instrumental to th...

Until recently, deactivation of a hospice’s Medicare provider number seemed like an action reserved for egregious conduct. But with law changes and an enhanced focus on enrollment, good hospices have found themselves facing a stop in their Medicare payments. Listen in as Husch Blackwell’s Adam Royal and Meg Pekarske discuss what has led to recent deactivations and how hospices can avoid the same f...

It’s that time of year again when HIS and CAHPS non-compliance letters are sent out. While it can be an uphill battle, all may not be lost if you receive a notice of non-compliance. Join Husch Blackwell's  Meg Pekarske as she talks with Jacob Harris , who shares insights on what matters in these appeals and how he helped so many hospices across the country over the last several years avoid detrime...

It’s never a dull moment when you are a labor and employment lawyer these days! Beyond the steady rise in union activity (a topic of a  prior podcast ), the administration has issued two rules that are garnering much attention, and being contested in court, involving non-competes and when an employee can be considered exempt from overtime requirements. Husch Blackwell’s  Tom O’Day joins host  Meg...

Compliance gets a dust off with the new General Compliance Program Guidance released by the federal Office of the Inspector General (OIG) in November 2023. While there is a lot to digest, Husch Blackwell’s Josi Wergin and Natasha Sumner join host Meg Pekarske to break it down highlighting important differences from past guidance and key implementation considerations. They also read the tea leaves...

As member substitutions become an increasingly common method of affiliation for nonprofit hospices, hospices may encounter various opportunities for affiliation. Join Husch Blackwell’s Meg Pekarske and Adam Royal as they discuss what has—and hasn’t—worked in member substitutions, and issues to spot early in a transaction to determine its feasibility.

In this episode, Meg Pekarske is joined by  Jody Rudman , the leader of Husch Blackwell’s White Collar, Internal Investigations & Compliance group, where they explore the enforcement and privacy issues surrounding artificial intelligence. Jody shares insights on the most common types of cybersecurity issues and how to prevent them. A cutting-edge conversation to help ground you in this emerging ar...

Recovery Audit Contractors (RACs) have played a relatively limited role in the hospice space, often overshadowed by UPICs, SMRCs, and Center for Program Integrity audits. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki talk about a recent wave of record requests issued by a RAC named Performant that focus on GIP and Continuous Home Care, and some ideas about how to respond.

Hospice Targeted Probe and Educate reviews (TPEs) continue to be initiated all over the country. That means it’s time to check in with Husch Blackwell's Hospice team on the latest developments. In this episode, Meg Pekarske and Bryan Nowicki discuss a new TPE topic and describe both the time-tested and emerging strategies hospices can use to respond to these reviews.

It came as a surprise to our team when we learned that the Centers for Medicare & Medicaid Services (CMS) was ending the hospice component of Value-Based Insurance Design (VBID) on December 31, 2024. Upon learning this, Husch Blackwell’s Meg Pekarske contacted Chris Comeaux , the president and CEO of Teleios Collaborative Network , to see if he wanted to share his thoughts on this unexpected turn...

Five years ago, the U.S. Department of Health and Human Services Office of Inspector General (OIG) initiated audits of 13 hospices and published its findings in 13 separate reports. It appears that the OIG is at it again, as multiple hospices recently have received “engagement letters” from the OIG with directions to produce medical records for 100 randomly selected claims. In this episode, Husch...

The owner of a Louisiana hospice was indicted and then convicted of healthcare fraud. How did that happen? In this episode, Husch Blackwell's Meg Pekarske and Jonathan Porter talk about how a routine audit led to a whistleblower complaint by a hospice employee, which then led to the hospice owner’s criminal conviction following trial in November 2023. Most importantly, the pair discuss how other h...

In this episode, Husch Blackwell’s Meg Pekarske is joined by friend and industry veteran Kim Skehan. In this wide-ranging conversation, they explore not only the recent survey reforms but the ways in which Kim’s decades of work as a survey consultant to hospices and home health agencies shape how she approaches her new role leading accreditation at CHAP. Kim’s perspective is truly unique. This is...

The hospice industry saw many regulatory changes in 2023. In this episode, Husch Blackwell's Meg Pekarske , Andrew Brenton , and Adam Royal discuss some of the main regulatory changes from 2023 and what hospices should expect in 2024. 

Traditional hospice transactions are receiving increased regulatory scrutiny and headwinds. Amidst these challenges, many hospices are considering management services organizations as an alternative to traditional transactions. In this episode, Husch Blackwell's Meg Pekarske and Adam Royal discuss how management services organizations can help hospices achieve economies of scale while minimizing r...

An effective compliance program is the bedrock of any successful healthcare organization and behind every successful compliance program is a trusted relationship between the Compliance Officer and CEO. In this episode, Husch Blackwell’s Meg Pekarske is joined by Avow Hospice’s CEO, Jaysen Roa, and its Compliance Officer, Kerri Ervin, who share how they built their relationship and how it has evolv...

Centers for Medicare & Medicaid Services (CMS) devised a “Special Focus Program” to identify poor performing hospices and help them improve through more frequent surveys and technical assistance. CMS would also impose enforcement remedies and fines to further incentivize improvement. How to identify poor performing hospices, however, has sparked concern among the hospice community. In this episode...

For a variety of unfortunate reasons, some hospices found themselves facing a 4% rate reduction for non-compliance with either Hospice Item Set (HIS) or Consumer Assessment of Healthcare Providers & Systems (CAHPS) requirements. For the third year in a row, the Husch Blackwell hospice team successfully advocated that the penalty not be imposed on its clients and CMS agreed! In this episode, Husch...

CMS has criticized hospices for underutilizing general inpatient care (GIP) but has also specifically targeted GIP claims for audit and medical review. In addition to CMS’s standard tools for reviewing GIP claims, such as UPIC audits and TPEs, the OIG is now getting involved with a GIP audit of its own. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki discuss the divergent approac...

Join Husch Blackwell’s Meg Pekarske and Wendy Arends as they explore the new draft Merger Guidelines and what enforcement may look like in the future. Given the number of hospices looking to consolidate through mergers, joint ventures, and other types of affiliations, you won’t want to miss this episode.