Hospice Insights Podcast - Hospice Audit Updates: David Beats Goliath
Compliance Tip of the Day: Middle Managers as the Eyes and Ears of Compliance
Episode 365 -- Four Sanctions Cases Everyone Should Know
UPIC Audits
Compliance Tip of the Day: The role of Compliance in Auditing AI
California Employment News: Taking Advantage of the PAGA Reform – How Employers Can Lower Their Risk of PAGA Liability
Auditing Your Hotline and Case Management System
Hospice Insights Podcast - Controlling the Narrative: A New Tactic for Auditors and ALJs
Improving Your Code of Conduct
Now Is the Time to Conduct I-9 Audits: What's the Tea in L&E?
Preparing for — and Surviving — an OFCCP Audit
Hospice Insights Podcast - Meet the New Laws, Same as the Old Laws: Overpayment Recoupment Update
AGG Talks: Home Health & Hospice Podcast - Episode 6: Navigating the Audit Maze: Insights From Northeast Georgia Health System
Hospice Insights Podcast - What's the Latest on UPICs? Highlights From Recent Audit Activity, Part II
5 Key Takeaways | 2024 Emerging Trends: Delaware Unclaimed Property VDA and Multistate Audits
Common Scenarios Triggering False Claims Act Violations, Part 3: Claims and Investigations
Compliance Tip of the Day: Machine Learning for Internal Audit
DE Under 3: OFCCP Changes Up Important Technical Details of its Audit Selection Process in First FY 2024 CSAL
Preparing for a Government Healthcare Audit
What Can A Tax Attorney Do For You? A Podcast With Janathan Allen
Grounded in the OIG’s General Compliance Program Guidance and DOJ’s Evaluation of Corporate Compliance Programs, our immersive, three-and-a-half-day, classroom-style Healthcare Basic Compliance Academy equips compliance...more
Hospice audits can have profound financial implications, particularly when the auditors use statistical extrapolation to identify an overpayment amount. The use of extrapolation runs across auditor types, including UPICs and...more
Hospices that have gone through audits are familiar with certain recurring reasons why auditors deny claims. Two common reasons are the lack of support for a six-month prognosis and the insufficiency of the physician...more
On November 12, 2024, OIG published a report concluding that the Medicare program overpaid acute-care hospitals an estimated $190 million over five years for outpatient services provided to hospice enrollees....more
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...more
In this episode, AGG Post-Acute & Long-Term Care co-chair Jason Bring is joined by Kathy Barton and Natalie McNeal of Northeast Georgia Health System. Kathy and Natalie share insights on navigating the complexities of hospice...more
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...more
For over a year, the hospice industry, legislators, and state and federal regulators have expressed concerns about the fast growth and potentially unscrupulous activities of new hospices in several states in particular. Those...more
In this episode, Jason Bring, AGG Healthcare partner and co-chair of the Post-Acute & Long-Term Care team, and Lanchi Nguyen Bombalier, AGG Healthcare partner and member of the Post-Acute & Long-Term Care, Hospitals & Health...more
In 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,...more
The Department of Health and Human Services Office of the Inspector General (OIG) recently released a report detailing its evaluation of CMS’s primary fraud, abuse and waste investigators—the Unified Program Integrity...more
After more than two years since the initial Provider Relief Fund (“Fund”) disbursement, hospices are beginning to see audits of their Fund expenditures by the U.S. Department of Health & Human Services (“HHS”) Office of the...more
The HHS Office of Inspector General (OIG) has, for the last several years, been actively auditing hospices regarding their Medicare regulatory and billing compliance, with a national hospice audit in the works. Recently, OIG...more
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...more
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...more
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...more
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...more
As audit activity escalates, hospices are getting increasingly familiar with the alphabet soup of audits and auditors, including OIG, UPIC, CMS, CPI, SMRC, MAC, TPE and more. Unfortunately, there are times when hospices are...more
The HHS Office of Inspector General (OIG) recently announced its Office of Audit Services plans to conduct a nationwide review of hospice eligibility, focusing on those Medicare hospice beneficiaries who haven't had an...more
In today’s episode, Husch Blackwell’s Meg Pekarske talks with team members Bryan Nowicki and Erin Burns about two recent developments in the hospice audit arena. First, the Centers for Medicare & Medicaid Services (CMS)...more
On September 1, 2021, as hospice providers continue to grapple with the demands of the ongoing pandemic, the Centers for Medicare & Medicaid Services (CMS) ended its temporary suspension of the Targeted Probe and Educate...more
Learning Objectives: - Discuss OIG work planning process, work plan items, and other government reports - Provider insights into COVID-19 audits, reviews, and monitoring... During this program, we will provide an...more
In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki discuss the new wave of CMS Center for Program Integrity (CPI) audits that have been issued during the past couple weeks. These CPI audits remain focused on...more
Today's Episode: Spring Audit Bloom—Medicaid UPICs and MAC ADRs Today, Husch Blackwell's Meg Pekarske is joined by colleagues Bryan Nowicki and Erin Burns to discuss the recent flurry of audit activity, specifically the...more
Hospice Audits 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...more