Recently, there has been an uptick in contractor participation at the ALJ stage of hospice audit appeals. This development poses unique challenges and new advocacy opportunities for providers. In this episode, Husch...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
The hospice physician plays an enormously critical role in hospice operations, from certifying patients as terminally ill to being the hospice’s representative in the community. Just as the physician’s role is critical, so...more
The hospice certification of terminal illness is one of the documents most scrutinized by Medicare contractors, and it is of critical importance since an invalid certification can impact Medicare payment for the patient’s...more
Husch Blackwell’s Meg Pekarske is joined today by Mary Kay Tyler, Chief Quality and Compliance Officer of Hospice of the Western Reserve, who shares strategies for achieving the elusive goal of improved clinical...more
Hospices are increasingly looking to buy, consolidate or merge to achieve administrative efficiencies and expand growth opportunities. Transactions between hospices present unique regulatory challenges that shape corporate...more
COVID-19 remained a substantial obstacle to hospices’ efforts to comply with quality data reporting obligations in 2021. Those challenges resulted in a number of hospices receiving notices of a 2% Medicare payment reduction...more
The hospice election may be the single most important document for hospices since an invalid form can impact payment for a patient’s entire stay. Especially in light of a recent rise in Medicare claim denials related to the...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
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...more
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...more
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...more
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...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
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...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
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,...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
In this era of disruption and market consolidation, the talk of the town is how hospices can make strategic pivots to expand their geography, diversify the scope of their services to get further upstream, and otherwise be...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
As we explored in our podcast on June 30, 2021, there is no one way for hospices to collaborate and position themselves for value-based care. In today’s episode, Husch Blackwell’s Meg Pekarske has the great pleasure to be...more
In a follow-up to its recent reports on billing outside the hospice benefit for drugs and durable medical equipment (DME), the Office of Inspector General’s (OIG) new data report identifies billions being billed to Medicare...more
Today, Husch Blackwell’s Meg Pekarske has the great pleasure to be joined by two of the founders of the Institute for Story, Jamey Espina and Dr. Berry, who is also a best-selling author and top change management speaker,...more
The Office of Inspector General (OIG) recently announced that its 2022 work plan for hospices will include a nationwide review of hospice beneficiary eligibility. In this episode, Husch Blackwell’s Meg Pekarske and Bryan...more
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...more