Hospice Insights: The Law and Beyond

For the last two-and-a-half years, hospices and other providers have been using billions in Provider Relief Fund (PRF) payments to prepare for, respond to and recover from the COVID-19 pandemic. The Office of Inspector General (OIG) has begun its nationwide audit of providers’ use of PRF payments, removing any remaining doubt as to whether these payments came with very significant strings attached...

Husch Blackwell’s Meg Pekarske is very excited to be joined by Jaysen Roa , President and CEO of Avow Hospice in Naples, Florida. Jaysen is a leader of action who is finding new ways to approach and solve the challenges facing the hospice industry. He is leveraging technology to provide better and more responsive hospice care at the end of life. He is also collaborating with other hospices through...

In this episode, we continue our discussion of home health enforcement trends, focusing on other audits currently troubling agencies. These include audits from Unified Program Integrity Contractors (UPIC), Supplemental Medical Review Contractors (SMRC) and the Targeted Probe and Educate (TPE) program by the Centers for Medicare and Medicaid Services (CMS). As on the hospice side, these audits can...

In a prior podcast, we alerted you to the Office of Inspector General’s (OIG) nationwide review of hospice beneficiary eligibility. The OIG has begun sending out requests for records to hospices across the country. In this episode, Husch Blackwell’s Meg Pekarske , Bryan Nowicki and Erin Burns discuss what hospices can expect and what they should do.

Each July, the Medicare Administrative Contractors issue notices of a 2% Medicare payment reduction to those providers who did not meet quality data reporting requirements. Those notices have been sent. In this episode, Husch Blackwell’s Meg Pekarske and Jacob Harris talk about the issues providers faced in 2021 and how to pursue an appeal of the 2% payment reduction.

As many hospices continue to diversify into new business lines, staying abreast of enforcement trends outside of hospice is more important than ever. Home health in particular, is receiving significant government scrutiny. In this episode, Husch Blackwell’s Meg Pekarske talks with Bryan Nowicki and Erin Burns about a new round of home health audits being conducted by the Office of Inspector Genera...

When confronted with a complaint, allegation or event that implicates a potential Medicare overpayment, hospices have an affirmative duty under the federal 60-day repayment rule to conduct an investigation and refund any overpayment. In this episode, Husch Blackwell’s Meg Pekarske and Andrew Brenton share tips and tools for conducting internal investigations and determining when an issue implicate...

The core of most hospice audits has been, and continues to be, whether the medical record supports the patient’s hospice eligibility. In this episode, Husch Blackwell’s Meg Pekarske talks with Bryan Nowicki and Zaina Niles about strategies for showing how a medical record supports a patient’s six-month prognosis.

The Centers for Medicare & Medicaid Services (CMS) has recently started mailing letters inviting physicians to one-on-one training sessions about the Medicare hospice benefit. In this episode, Husch Blackwell’s Meg Pekarske , Bryan Nowicki and Claire Postman talk about what these training sessions involve, why CMS is conducting them, and how physicians and hospices can respond.

Unified Program Integrity Contractor (UPIC) audits are on the rise, and the UPICs are embracing the full array of enforcement tools at their disposal. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki  discuss the ways that UPICs can put pressure on hospices and how hospices can respond.

Strategic Restructuring for the Future: Exploring How Hospices Are Using Joint Ventures, Mergers and Acquisitions, and Service Diversification to Transform Change, transformation, disruption: whatever you want to call it, it’s happening in the hospice industry over the next 5 years. It is unquestionable that the carve-in to Medicare Advantage, the rise of value-based care and steady market consoli...

Hospice Audit Series Audits are a fact of life for hospices—it’s not a matter of “if” a hospice will be audited, but “when.” The alphabet soup of audits has expanded, from UPICs to SMRCs, CPIs, TPEs and more. With the hospice carve-in to Medicare Advantage, MAO audits will join the list. The recent pause in audits as a result of the COVID pandemic hints at increased activity as the pandemic wanes....

Strategic Restructuring for the Future: Exploring How Hospices Are Using Joint Ventures, Mergers and Acquisitions, and Service Diversification to Transform Change, transformation, disruption: whatever you want to call it, it’s happening in the hospice industry over the next 5 years. It is unquestionable that the carve-in to Medicare Advantage, the rise of value-based care and steady market consoli...

Hospice Audit Series Audits are a fact of life for hospices—it’s not a matter of “if” a hospice will be audited, but “when.” The alphabet soup of audits has expanded, from UPICs to SMRCs, CPIs, TPEs and more. With the hospice carve-in to Medicare Advantage, MAO audits will join the list. The recent pause in audits as a result of the COVID pandemic hints at increased activity as the pandemic wanes....

Welcome to an inspiring conversation on how story can help us reconnect with mission, staff and communities. As hospices face unprecedented staffing shortages and a burnt-out workforce, a key to thriving may be to re-engage with our human essence, which can be found through story. Today’s guest, Dr. Bertice Berry, PhD , explains humans are hardwired for story—it is how we connect, reflect and grow...

Hospice Audit Series Audits are a fact of life for hospices—it’s not a matter of “if” a hospice will be audited, but “when.” The alphabet soup of audits has expanded, from UPICs to SMRCs, CPIs, TPEs and more. With the hospice carve-in to Medicare Advantage, MAO audits will join the list. The recent pause in audits as a result of the COVID pandemic hints at increased activity as the pandemic wanes....

Our hospice team has been fielding questions from hospices across the country on administering COVID-19 vaccination requirements. In this episode, Husch Blackwell’s Meg Pekarske is joined by colleague Jessica Brown , where they discuss the most pressing vaccination issues and how to navigate them. They explore strategies for handling vendors, the role unvaccinated staff can have in direct patient...

Providing hospice care to vulnerable individuals can embroil hospices in a variety of unwanted situations. The emotions surrounding the death of a loved one can cause families and caregivers to question the kind of care provided. These sensitive circumstances can also lead to disputes between family members, or between the family and other providers or facilities, with the hospice often stuck in t...

Hospices’ unique regulatory and business environment impacts how they contract with and relate to other private entities. In this episode, Husch Blackwell’s Meg Pekarske , Bryan Nowicki and Jake Harris discuss the many kinds of hospice-related contracts and contract-dispute matters they have worked on, and how their clients benefitted from their in-depth knowledge of hospices.

Hospices and the False Claims Act Series The False Claims Act (FCA) is the government’s most serious weapon to combat fraud in the healthcare community, and hospices are increasingly the target of FCA investigations and lawsuits. The United States Supreme Court is, for the first time, considering FCA cases involving hospices and certifications of terminal illness. Moreover, the relief funds disbur...

Strategic Restructuring for the Future: Exploring How Hospices Are Using Joint Ventures, Mergers and Acquisitions, and Service Diversification to Transform Change, transformation, disruption: whatever you want to call it, it’s happening in the hospice industry over the next 5 years. It is unquestionable that the carve-in to Medicare Advantage, the rise of value-based care and steady market consoli...

What is the latest on vaccine mandates? In this episode, Husch Blackwell's Meg Pekarske is joined by colleague Tom O’Day to discuss the newly released OSHA and CMS rules. They'll uncover the surprises, discuss how to implement the requirements and analyze the challenges that may be on the horizon for hospices. Tune in to this lively and helpful conversation.

Hospice Audit Series Audits are a fact of life for hospices—it’s not a matter of “if” a hospice will be audited, but “when.” The alphabet soup of audits has expanded, from UPICs to SMRCs, CPIs, TPEs and more. With the hospice carve-in to Medicare Advantage, MAO audits will join the list. The recent pause in audits as a result of the COVID pandemic hints at increased activity as the pandemic wanes....

Hospice Audit Series Audits are a fact of life for hospices—it’s not a matter of “if” a hospice will be audited, but “when.” The alphabet soup of audits has expanded, from UPICs to SMRCs, CPIs, TPEs and more. With the hospice carve-in to Medicare Advantage, MAO audits will join the list. The recent pause in audits as a result of the COVID pandemic hints at increased activity as the pandemic wanes....

In this episode, Husch Blackwell's Meg Pekarske chats with colleagues Bryan Nowicki and Jacob Harris , who share what happened with the Hospice Item Set (HIS) noncompliance letters. You have to listen—did hospices win or lose?