Avsnitt
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The United States Supreme Court recently overruled decades-old precedent that favored an administrative agency’s interpretation of ambiguous statutes. This seismic shift in the role of the judiciary will affect every regulated industry, including healthcare and hospice in particular. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki discuss the implications of this decision in the hospice space.
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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 identified updates to the Medicare Financial Management Manual relating to these options. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki discuss those updates which, practically speaking, do not significantly change the existing options.
Additional Resources:
MM 11808 - Limitation on Recoupment of Medicare Overpayments
CR 11808 - Updating Chapter 3, Sections 200.5 - 200.8, Limitation on Recoupment; Medicare Overpayments Manual
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In this episode, Husch Blackwell’s Meg Pekarske is joined by long-time hospice friend and industry guru Greg Grabowski. They turned the microphone on their usually private (but always lively) discussions on what’s going on in the wide world of hospice. To make it especially fun, they each prepared, but did not share prior to recording, their own list of what’s working and not working in hospice right now. Listen in to see how their observations match up.
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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 home room and board payments, patient interviews, and more. Meg and Bryan also describe some handouts they’ve developed to help hospices stay prepared for the inevitable audit.
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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 board payments, patient interviews, and more. Meg and Bryan also describe some handouts they’ve developed to help hospices stay prepared for the inevitable audit.
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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 to find out, as Husch Blackwell’s Meg Pekarske is joined by HopeHealth CEO Diana Franchitto and Dr. Edward Martin, CMO, whose trusted relationship has been instrumental to the organization’s success and clinical expansion. Whether it be forging new community partnerships or advocating for patients, Diana and Ed bring a wonderful compliment of strengths to advancing end-of-life care in their community. Listen in…be inspired!
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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 stop in their Medicare payments. Listen in as Husch Blackwell’s Adam Royal and Meg Pekarske discuss what has led to recent deactivations and how hospices can avoid the same fate.
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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 talks with Jacob Harris, who shares insights on what matters in these appeals and how he helped so many hospices across the country over the last several years avoid detrimental rate cuts. The key takeaways are: 1. don’t assume nothing can be done and 2. it’s always worth exploring whether your facts may warrant pursuing an appeal.
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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, and being contested in court, involving non-competes and when an employee can be considered exempt from overtime requirements. Husch Blackwell’s Tom O’Day joins host Meg Pekarske to discuss what these new rules mean for hospices and what you should be doing now to stay prepared. This is a great listen!
Additional Resources:
Federal Trade Commission (FTC) Non-Compete Clause Rule
Department of Labor (DOL) Rule on Overtime Exemptions
The Impact of the FTC’s Ban on Noncompete Agreements in the Health Care Industry
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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 Natasha Sumner join host Meg Pekarske to break it down highlighting important differences from past guidance and key implementation considerations. They also read the tea leaves on what to expect in forthcoming hospice specific compliance guidance. An important listen for everyone in hospice!
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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 discuss what has—and hasn’t—worked in member substitutions, and issues to spot early in a transaction to determine its feasibility.
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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 intelligence. Jody shares insights on the most common types of cybersecurity issues and how to prevent them. A cutting-edge conversation to help ground you in this emerging area.
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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 Bryan Nowicki talk about a recent wave of record requests issued by a RAC named Performant that focus on GIP and Continuous Home Care, and some ideas about how to respond.
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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 and Bryan Nowicki discuss a new TPE topic and describe both the time-tested and emerging strategies hospices can use to respond to these reviews.
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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 Blackwell’s Meg Pekarske contacted Chris Comeaux, the president and CEO of Teleios Collaborative Network, to see if he wanted to share his thoughts on this unexpected turn of events and what may be on the horizon. This is a forward-looking conversation where we explore how the lessons learned can galvanize new advocacy on the best ways to care for patients with advanced illnesses.
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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 multiple hospices recently have received “engagement letters” from the OIG with directions to produce medical records for 100 randomly selected claims. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki discuss these OIG audits, strategies for responding, and their implications for the hospice community.
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The 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 owner’s criminal conviction following trial in November 2023. Most importantly, the pair discuss how other hospices can avoid that fate.
Additional resource:
Jury Convicts Hospice Owner for Defrauding Medicare -
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 work as a survey consultant to hospices and home health agencies shape how she approaches her new role leading accreditation at CHAP. Kim’s perspective is truly unique. This is a must listen for everyone looking to successfully navigate the survey process.
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The 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.
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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 transactions. In this episode, Husch Blackwell's Meg Pekarske and Adam Royal discuss how management services organizations can help hospices achieve economies of scale while minimizing regulatory scrutiny.
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