Hospice Insights Podcast - Where’s the Line: When Does Poor Quality Create False Claims Liability
Hospice Insights Podcast - Hospice Audit Updates: Hospices Fare Well in Federal Court
Hospice Insights Podcast - AI in Action: Exploring How AI Is Helping Hospices Do Things in New Ways
Hospice Insights Podcast - Election Inspection: Be Proactive to Avoid Costly Election Statement Denials
Hospice Insights Podcast - Still Number One: Healthcare Fraud Remains Central in DOJ’s White Collar Enforcement Plan
Podcast - Innovations and Insights in the Palliative Care Space
Hospice Insights Podcast - Hospice Audit Updates: David Beats Goliath
Hospice Insights Podcast - But Wait: Things to Consider Before Adopting AI Tools In Your Hospice
AGG Talks: Home Health & Hospice Podcast - Episode 10: Anti-Kickback Compliance for Hospice and Skilled Nursing Providers
Hospice Insights Podcast - One Size Doesn’t Fit All: Figuring Out What is Your Hospice+
Hospice Insights Podcast - Psychedelics and End of Life Care: Understanding the Legal Landscape
AGG Talks: Home Health & Hospice Podcast - Episode 9: The Impact of AI and Prior Authorizations on Home Health and Hospice
Hospice Insights Podcast - Controlling the Narrative: A New Tactic for Auditors and ALJs
AGG Talks: Home Health & Hospice Podcast - Episode 8: Hospice Special Focus Program: Pumping the Brakes
Hospice Insights Podcast - Upping the Ante: Will CMS’s Enhanced Oversight Efforts Cause Hospices to Fold?
Hospice Insights Podcast - A Year in Review: Reflections and Hopes for the Future
Hospice Insights Podcast - What a Difference No Deference Makes: Courts No Longer Bow to Administrative Agencies
AGG Talks: Home Health & Hospice Podcast - Episode 7: OIG Report Reveals Gaps in Hospice PRF Compliance: What Providers Need to Know
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
On April 11, 2025, CMS issued a proposed rule that “would update the hospice wage index, payment rates, and cap amount for FY 2026” as required under the Social Security Act, clarify payment regulations on admission to...more
News Briefs - Proposed Budget Cuts Could Greatly Impact Healthcare Sector - House Republicans unveiled a budget resolution that asks the Energy and Commerce Committee, which oversees Medicare and Medicaid, to find $880...more
News Briefs - New FDA Guidelines Aim to Make TV Drug Ads Clearer, More Direct - The ever-present TV drug ads showing patients hiking, biking, or enjoying a day at the beach could soon have a different look, as new rules...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
News Briefs - 75% of Hospitals Spending More on Tech to Boost Cybersecurity - Three-quarters of hospitals and health systems spent more on information technology last year and many will continue to do so, with greater focus...more
Looking for a simple, easy-to-implement way to lower your risk of overpayments? We have one on this week’s podcast!...more
A New Jersey hospice provider must continue its long fight against whistleblowers alleging it violated the False Claims Act (“FCA”) by seeking Medicare reimbursement for patients whose documentation did not support hospice...more
News Briefs - More States Introducing 'Conscience' Healthcare Bills - A new Montana law will provide sweeping legal protections to healthcare practitioners who refuse to prescribe marijuana or participate in procedures and...more
Report on Medicare Compliance Volume 32, no 25 (July 2023) Hospices in four states will face heightened oversight. “CMS is placing newly enrolling hospices located in Arizona, California, Nevada, and Texas in a provisional...more
Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us virtually at HCCA’s Annual Healthcare Enforcement Compliance...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
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
The United States Supreme Court denied certiorari without comment in two cases seeking to resolve a Circuit split regarding the proof required to establish that a claim for payment was false or fraudulent under the False...more
For several years, courts have wrestled with the question of whether subjective clinical decisions regarding the type and amount of treatment patients may need can be false for purposes of establishing False Claims Act (FCA)...more
In its conference on Feb. 19, the U.S. Supreme Court is scheduled to consider two pending petitions for certiorari that could resolve a critical but deeply disputed issue that impacts both the False Claims Act and health care...more
As we approach the 40th anniversary of the Medicare hospice benefit, we stand at an important reflection point to evaluate end-of-life care and map its future. In this new series, we gather leaders and thinkers from a range...more
COVID-19 has affected all aspects of hospice care, operations and personnel, including the person whose judgment is at the center of the Medicare hospice benefit: the hospice physician. From new regulations addressing...more
Last week, the Third Circuit joined several other appellate courts in finding that medical opinions related to medical necessity of hospice services can be subject to scrutiny and found to be “false” for purposes of proving a...more
The United States Court of Appeals for the Third Circuit ruled last week that whistleblower relators need not show “objective falsity” to prove their claims, and that a dispute among physician experts about a clinical...more
All hospice providers routinely should assess risk exposure under the False Claims Act — now with the benefit of the U.S. Court of Appeals for the Eleventh Circuit’s long-awaited decision in United States v. AseraCare Inc. ...more
Discover the factors that drove healthcare M&A activity in 2019. Innovation, expansion and continued private equity investment in the industry influenced healthcare transactions last year. 2019 saw continued robust...more
• Reasonable disagreement among clinicians, by itself, does not result in a false claim. • Clinical judgment must be objectively false to constitute an FCA violation. • A clinical judgment may only be objectively false...more
The 11th Circuit’s long-awaited AseraCare opinion requires more than mere disagreement regarding clinical judgment to prove falsity under the False Claims Act. The 11th Circuit rejected the government’s theory of falsity...more
On September 9, 2019, the Eleventh Circuit issued a highly anticipated opinion addressing the critical question of when Medicare claims for reimbursement (in this case, claims for hospice care) can be considered “false” under...more
A new federal court decision offers a ray of light to those providers defending false claims actions based on an alleged lack of medical necessity. On September 9, 2019, the United States Court of Appeals for the Eleventh...more