Latest Hospice law Podcast Episodes
An Ounce of Prevention: Keys to Understanding and Preventing AI and Cybersecurity Risks
Hospice Insights: The Law and Beyond - May 01, 2024 18:23 - 26 minutesIn 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 cybersecur...
A Command Performant(s): RAC Audits on the Rise
Hospice Insights: The Law and Beyond - April 17, 2024 16:25 - 10 minutesRecovery 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...
The TPE Carousel. . . Around and Around We Go
Hospice Insights: The Law and Beyond - April 03, 2024 19:34 - 15 minutesHospice 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-tes...
A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Hospice Insights: The Law and Beyond - March 13, 2024 18:55 - 35 minutesIt 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 CE...
OMG. . .The OIG is at it Again
Hospice Insights: The Law and Beyond - February 28, 2024 15:46 - 17 minutesFive 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 ...
How One Hospice Owner Got Convicted of Healthcare Fraud and How You Can Avoid That Fate
Hospice Insights: The Law and Beyond - February 21, 2024 21:17 - 30 minutesThe 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 owne...
Hospice and Home Health Survey Perspectives: A Conversation with Kim Skehan, VP of Accreditation at CHAP
Hospice Insights: The Law and Beyond - January 31, 2024 19:35 - 49 minutesIn 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 ho...
Year in Review: Key Regulatory Updates in 2023
Hospice Insights: The Law and Beyond - January 10, 2024 19:30 - 28 minutesThe 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.
An Alternative to Consolidations: Key Considerations for Management Services Organizations
Hospice Insights: The Law and Beyond - December 13, 2023 19:39 - 26 minutesTraditional 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 discu...
Stories of Successful Hospice Leadership: The CEO and Compliance Officer Relationship
Hospice Insights: The Law and Beyond - November 29, 2023 17:45 - 36 minutesAn 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, a...
A Very “Special” Episode: Amid Controversy, CMS Launches the Hospice Special Focus Program
Hospice Insights: The Law and Beyond - November 06, 2023 21:04 - 20 minutesCenters 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 iden...
Grace from CMS: Unexpected Good News on HIS and CAHPS Appeals
Hospice Insights: The Law and Beyond - November 01, 2023 19:09 - 11 minutesFor 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 succe...
This Bandwagon Has a Broken Wheel: OIG Joins the Inconsistent Approach to Hospice GIP Claims
Hospice Insights: The Law and Beyond - October 18, 2023 21:12 - 18 minutesCMS 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 ...
A Significant Departure: Unpacking What the New Antitrust Guidelines Mean for Healthcare Providers
Hospice Insights: The Law and Beyond - October 04, 2023 21:23 - 29 minutesJoin 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...
The Gift That Keeps On Giving: TPE Insights and Strategies
Hospice Insights: The Law and Beyond - September 20, 2023 21:29 - 18 minutesWhile not new, the number and scope of Targeted Probe and Educate (TPE) reviews have soared to new heights. At the same time, more hospices are facing the uncomfortable position of moving to a second and sometimes third round of review. In this episode, Husch Blackwell’s Meg Pekarske and Bryan N...
Behind the Curtain: Enhanced Provider Enrollment Oversight
Hospice Insights: The Law and Beyond - September 06, 2023 21:27 - 43 minutesIn the midst of consolidation and restructuring among hospices, the Centers for Medicare & Medicaid Services (CMS) is scrutinizing initial enrollments and changes in ownership and management. In this episode, Husch Blackwell’s Meg Pekarske and Adam Royal discuss new and proposed changes to CMS’s...
What Does It Mean? Understanding the Practical Implications of the New 36-Month Rule for Hospices
Hospice Insights: The Law and Beyond - August 23, 2023 20:51 - 19 minutesIt’s been hard to keep track of all the new changes related to government oversight of hospices. This growing list now includes an expansion of the 36-month rule to hospices, which will limit the frequency that hospices can change ownership. There are important exceptions to the rule that all ho...
Survey Woes: CMS Ramps Up Hospice Survey Program and Consequences
Hospice Insights: The Law and Beyond - August 09, 2023 21:21 - 22 minutesHospices have been the target of increased government scrutiny in 2023, and the Centers for Medicare and Medicaid Services (CMS) is planning to take further aim in 2024 through surveys. Join Husch Blackwell’s Meg Pekarske, Emily Solum, and Erin Burns as they talk about a cautionary survey tale a...
Joining Forces: Consolidation Through Member Substitutions
Hospice Insights: The Law and Beyond - July 26, 2023 21:02 - 30 minutesHospices are increasingly looking to buy, consolidate, or merge to achieve administrative efficiencies and expand operations for growth. A common approach among nonprofit hospices is to combine through a member substitution. In today’s episode, Husch Blackwell’s Meg Pekarske and Adam Royal discu...
Show Me the Money: New Study Confirms Hospice Saves Money for Medicare
Hospice Insights: The Law and Beyond - July 12, 2023 20:52 - 17 minutesA study published by NORC at the University of Chicago, a nonpartisan research organization, concluded that the Hospice Benefit saved Medicare $3.5 billion in 2019. The data behind that figure, and the study’s related findings, show that the value of the Medicare Hospice Benefit appears to be at...
After ALJ: Options and Opportunities in the Face of an Unfavorable ALJ Decision
Hospice Insights: The Law and Beyond - June 22, 2023 19:37 - 21 minutesIn the five-step audit appeals process, hospices often stop their appeal efforts after finding success at the third step, a hearing before an administrative law judge (ALJ). However, if an ALJ issues an unfavorable decision, the hospice still has recourse. In this episode, Husch Blackwell’s Meg ...
An Unwanted Spotlight: DOJ Announces Hospice Fraud Is Top Priority
Hospice Insights: The Law and Beyond - June 07, 2023 21:03 - 18 minutesIn this episode, Husch Blackwell’s Meg Pekarske and Jonathan Porter, a former federal prosecutor, discuss takeaways from the recent American Bar Association’s Annual National Institute on Health Care Fraud. Most importantly, they will explore what the hospice industry can expect after hearing th...
A Glimpse Into the Other Side: Understanding the Perspective of Government Enforcers
Hospice Insights: The Law and Beyond - May 24, 2023 21:18 - 30 minutesHospice professionals are often left wondering how the Centers for Medicare and Medicaid Services (CMS) and other government entities identify enforcement priorities. They also seek understanding about the subsequent steps taken for audits and False Claims Act investigations. In this episode, Hu...
I Understood There Would Be No Math: Audits, Extrapolations, and a New Set of Rules
Hospice Insights: The Law and Beyond - May 10, 2023 21:18 - 12 minutesAudits that employ statistical extrapolation can turn a handful of claim denials into a liability of hundreds of thousands or millions of dollars. After years of relative quiet, the statisticians are back. The Centers for Medicare and Medicaid Services (CMS) also modified the rules relating to e...
Quick Takeaways From the 2024 Proposed Hospice Wage Index Rule
Hospice Insights: The Law and Beyond - April 26, 2023 21:06 - 22 minutesEarlier this spring, as part of its annual rulemaking process for hospices, the Centers for Medicare and Medicaid Services (CMS) issued several important regulatory proposals. In addition to the yearly update in hospice per diem rates, the proposed rule clarifies the end dates for hospices to us...
Business Associates Here, There, and Everywhere: When Does Your Service Provider Really Need to Sign a HIPAA Business Associate Agreement?
Hospice Insights: The Law and Beyond - April 12, 2023 21:13 - 14 minutesThe HIPAA regulations require that covered entities enter into agreements with business associates who provide certain services for the covered entity involving the receipt, use, or disclosure of protected health information. In working with hospices throughout the years, we have found that many...
Heed Caution: Takeaways From the OIG’s Advance Care Planning Report
Hospice Insights: The Law and Beyond - March 29, 2023 17:42 - 15 minutesThe U.S. Department of Health and Human Services’ Office of Inspector General (OIG) reported in November 2022 that many providers are not complying with Medicare’s billing rules for advance care planning services. In large part, the OIG’s findings centered around providers failing to document se...
David v. Goliath: Taking on Payment Suspension and Extrapolation
Hospice Insights: The Law and Beyond - March 15, 2023 21:12 - 17 minutesPayment suspension and overpayment extrapolation are among the most extreme and effective enforcement tools available to the Centers for Medicare and Medicaid Services (CMS) and its auditors. However, even these measures can be overcome. In this episode, Husch Blackwell’s Meg Pekarske, Bryan Now...
The Rules They Are A-Changin’: CMS Proposes a Significant Change to the 60-Day Repayment Rule
Hospice Insights: The Law and Beyond - March 01, 2023 22:13 - 12 minutesThe Centers for Medicare and Medicaid Services (CMS) unexpectedly proposed a rule change that could have a significant impact on how hospices investigate compliance issues and take remedial action. The rule change directly affects potential liability under the federal False Claims Act. Therefore...
On the Road With Your Hospice Team: A Report From Home Care 100
Hospice Insights: The Law and Beyond - February 15, 2023 22:19 - 13 minutesThe Home Care 100 Leadership Conference is an annual gathering of top leaders and innovators in the hospice and home health community. Presentations and informal discussions address the current state of the industry and what will drive future survival and success. In this episode, Husch Blackwel...
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