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...more
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...more
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...more
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...more
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,...more
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...more
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...more
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...more
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...more
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...more
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...more
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...more
The owner of a Louisiana hospice was indicted and then convicted of healthcare fraud. How did that happen? In this episode of Hospice Insights: The Law and Beyond, Husch Blackwell's Meg Pekarske and Jonathan Porter talk about...more
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...more
The hospice industry saw many regulatory changes in 2023. In this episode of Hospice Insights: The Law and Beyond, Husch Blackwell's Meg Pekarske, Andrew Brenton, and Adam Royal discuss some of the main regulatory changes...more
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...more
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...more
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...more
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)...more
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...more
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...more
While 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...more
In 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...more
It’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...more
Hospices 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,...more