Hospice Insights: The Law and Beyond

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....

By October 1, 2021, hospices will need to update their election addendum form to address a change made by the Centers for Medicare & Medicaid Services (CMS) in the final rule. The government has provided much-needed clarification and flexibility to certain aspects regarding the addendum. When should hospices provide the addendum to patients? What should hospices do if a patient refuses a signer’s...

After exploring the attributes of a well-functioning board, in this episode we delve into common practices and tendencies that can limit board performance. Whether it be factioning, side conversations or confidentiality leaks, there are activities that get in the way of good governance.  Husch Blackwell’s Meg Pekarske and Stephanie Kaiser talk through how to help leaders identify these roadblocks...

In this episode, Husch Blackwell’s Meg Pekarske and Jacob Harris unpack what may be behind the Hospice Item Set (HIS) noncompliance letters that many hospices believe they have erroneously received. These letters indicate hospices have not achieved compliance with the HIS reporting requirement. Meg and Jacob explore how the Centers for Medicare & Medicaid Services’ (CMS) temporary 6-month reportin...

Hospice 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 disburs...

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...

After nearly half a year of silence, the U.S. Department of Health and Human Services finally provided direction on when providers need to submit Provider Relief Fund (“PRF”) compliance reports. In this episode, Husch Blackwell’s Meg Pekarske and Andrew Brenton discuss this and other PRF developments, including new deadlines by which providers must use their PRF payments and guidance on how to ret...

Privacy Series In this series, we will explore all things privacy. From HIPAA breaches, to updates on the information blocking rule, to privacy enforcement trends, hospices will learn what they need to know to stay current in this evolving area of law.  Today's Episode: HIPAA Breaches - When It Is, and When It Is Not a Breach In today’s episode of our Hospice Privacy Series, Husch Blackwell’s Meg...

In today’s episode of Hospice Insights, Husch Blackwell’s Meg Pekarske shares her recent wide-ranging conversation with Dr. Kathleen Benton of Hospice Savannah, where they explore how good business planning starts and ends with good questions and strong ethics.  Applying a “buy local” philosophy to healthcare, Kathleen sees her future intwined with that of her community in that their needs define...

Hospice 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 disburs...

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....

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....

Hospice 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 disburs...

In this inaugural episode of our Hospice Audit Series, Husch Blackwell’s Meg Pekarske and Bryan Nowicki review three recent audit examples that resulted in multimillion-dollar extrapolated overpayments being thrown out by the Centers for Medicare & Medicaid Services. Meg and Bryan saved hospice clients over $50 million in alleged overpayments in these three audits alone! The strategies and argumen...

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...

The “rules of the road” for Provider Relief Funds continue to evolve. Recent actions by Congress and the U.S. Department of Health and Human Services provide further clarification in key areas that are helpful to hospices. In this episode, Husch Blackwell’s Meg Pekarske and Andrew Brenton analyze the latest developments and share insights on calculating lost revenue and preparing for compliance re...

The latest COVID Relief and Funding law passed in December 2020 brings dramatic changes to the hospice survey process. While CMS will need to engage in future rulemaking to implement the new framework, Congress created a clear outline that includes significant financial remedies and makes all survey results publicly available. In this episode, Husch Blackwell's Meg Pekarske breaks down key compone...

In this episode, Husch Blackwell's Meg Pekarske is joined by colleagues Jenna Brofsky , Erica Ash and Wakaba Tessier who provide an update on the legal landscape related to COVID-19 testing and vaccinations. Their conversation explores the liability protections provided by the PREP Act and the legal considerations hospices need to account for when establishing a vaccination program. They break dow...

In today’s conversation Husch Blackwell's Meg Pekarske sits down with William Finn , the CEO of Hospice of the Western Reserve, where they share stories of change, innovation and opportunity in hospice and palliative care. Bill, Meg likes to say, is a man who is always “up to something.” He sees change on the horizon and leans into the opportunities it provides. During his tenure at Hospice of the...

Join Husch Blackwell's  Meg Pekarske  as she further explores good governance in hospice. In this conversation, Meg is joined by fellow attorney  Stephanie E. Kaiser  as they delve into the details about how a “good” board functions, what are the common attributes and how you can measure performance. They discuss the role of sub-committees and term limits, what makes a good board agenda and minute...

With all that 2020 has brought, the Information Blocking Rule that came out of the Cures Act was under the radar of many hospices. Thankfully, HHS extended the compliance date for the Rule to April 5, 2021, from November 2, 2020. With this additional time, hospices need to evaluate how they will achieve compliance; what policies they need to update; the work they need to do with their EMR vendor;...

The AseraCare court decision benefited hospices and physicians, particularly by recognizing the uncertainty surrounding prognostication of a six-month life expectancy and the principle that two physicians can disagree about prognostication and neither be wrong. The decision’s future, however, is uncertain, as the U.S. Supreme Court may weigh in. In this episode, Meg Pekarske is joined by Bryan Now...