Hospice Insights: The Law and Beyond

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 Bl…

Hospices are increasingly looking to buy, consolidate, or merge to achieve administrative efficiencies and expand operations for growth. A common approach among nonprofit hospices is to combine throu…

A study published by NORC at the University of Chicago, a nonpartisan research organization, concluded that the Hospice Benefit saved Medicare $3.5 billion in 2019. The data behind that figure, and t…

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…

In this episode, Husch Blackwell’s Meg Pekarske and Jonathan Porter, a former federal prosecutor, discuss takeaways from the recent American Bar Association’s Annual National Institute on Health Care…

Hospice professionals are often left wondering how the Centers for Medicare and Medicaid Services (CMS) and other government entities identify enforcement priorities. They also seek understanding abo…

Audits that employ statistical extrapolation can turn a handful of claim denials into a liability of hundreds of thousands or millions of dollars. After years of relative quiet, the statisticians are…

Earlier this spring, as part of its annual rulemaking process for hospices, the Centers for Medicare and Medicaid Services (CMS) issued several important regulatory proposals. In addition to the year…

The HIPAA regulations require that covered entities enter into agreements with business associates who provide certain services for the covered entity involving the receipt, use, or disclosure of pro…

The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) reported in November 2022 that many providers are not complying with Medicare’s billing rules for advance care plan…

Payment suspension and overpayment extrapolation are among the most extreme and effective enforcement tools available to the Centers for Medicare and Medicaid Services (CMS) and its auditors. However…

The Centers for Medicare and Medicaid Services (CMS) unexpectedly proposed a rule change that could have a significant impact on how hospices investigate compliance issues and take remedial action. T…

The Home Care 100 Leadership Conference is an annual gathering of top leaders and innovators in the hospice and home health community. Presentations and informal discussions address the current state…

While direct patient billing may be less common for hospice patients than for patients receiving hospital or other types of care, there are aspects of the No Surprises Act and its implementing regula…

Recently, there has been an uptick in contractor participation at the administrative law judge (ALJ) stage of hospice audit appeals. This development poses unique challenges and new advocacy opportun…

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…

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…

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 pay…

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 impro…

Hospices are increasingly looking to buy, consolidate or merge to achieve administrative efficiencies and expand growth opportunities. Transactions between hospices present unique regulatory challeng…