Hospice Insights: The Law and Beyond - podcast cover

Hospice Insights: The Law and Beyond

Tune in to Husch Blackwell’s hospice podcast with Meg Pekarske for conversations with industry innovators and fundamentals for navigating hospice law. In our commitment to monitoring updates and fostering learning, each episode delivers essential information clients need for best solutions in this changing healthcare sector.
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Episodes

Hospice Innovators: A Conversation with Jaysen Roa, President and CEO of Avow Hospice

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 the hospice industry. He is leveraging technology to provide better and more responsive hospice care at the end of life. He is also collaborating with other hospices through the formation of Synthase Collaborative to improve efficiencies and work with new payors. Jaysen is...

Aug 31, 202251 minEp. 72

Beyond Hospice: Home Health Agencies Plagued by UPICs and SMRCs

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 Medical Review Contractors (SMRC) and the Targeted Probe and Educate (TPE) program by the Centers for Medicare and Medicaid Services (CMS). As on the hospice side, these audits can be an administrative burden and should be taken seriously. Husch Blackwell’s Meg Pekarske , Bryan No...

Aug 17, 202220 minEp. 71

Hospice Audit Series | It’s That Time of Year Again: Quality Data Reporting Determinations Raise New and Recurring Issues

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 Blackwell’s Meg Pekarske and Jacob Harris talk about the issues providers faced in 2021 and how to pursue an appeal of the 2% payment reduction....

Jul 20, 202214 minEp. 69

Beyond Hospice: The OIG Renews Its Scrutiny of Home Health Agencies

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 this episode, Husch Blackwell’s Meg Pekarske talks with Bryan Nowicki and Erin Burns about a new round of home health audits being conducted by the Office of Inspector General for the Department of Health and Human Services....

Jul 06, 202216 minEp. 68

Nuts and Bolts of a Repayment Investigation: Keys to Conducting Investigations Under the 60-Day Repayment Rule

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 overpayment. In this episode, Husch Blackwell’s Meg Pekarske and Andrew Brenton share tips and tools for conducting internal investigations and determining when an issue implicates payment....

Jun 22, 202223 minEp. 67

You’ve Got Mail: CMS Physician Outreach and How to Respond to It

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 , Bryan Nowicki and Claire Postman talk about what these training sessions involve, why CMS is conducting them, and how physicians and hospices can respond....

May 25, 202221 minEp. 65

Strategic Restructuring for the Future: Exploring Upstream Revenue Opportunities for Hospices

Strategic Restructuring for the Future: Exploring How Hospices Are Using Joint Ventures, Mergers and Acquisitions, and Service Diversification to Transform Change, transformation, disruption: whatever you want to call it, it’s happening in the hospice industry over the next 5 years. It is unquestionable that the carve-in to Medicare Advantage, the rise of value-based care and steady market consolidation is changing the playing field. How do hospices respond? In this series, we explore how hospic...

Apr 27, 202218 minEp. 63

Hospice Audit Series | Audit Overlap: Connections and Contradictions Among Audits, Auditors and What to Do About Them

Hospice Audit 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 hospice carve-in to Medicare Advantage, MAO audits will join the list. The recent pause in audits as a result of the COVID pandemic hints at increased activity as the pandemic wanes. In this series, Meg Pekarske and Bryan Nowicki of Husch Blackwell’s Hospice Audit team deconstruct ...

Apr 13, 202218 minEp. 62

Strategic Restructuring for the Future, Insights on Building a Hospice Network From the Ground Up: A Conversation With Mike Milward, CEO of the California Hospice Network

Strategic Restructuring for the Future: Exploring How Hospices Are Using Joint Ventures, Mergers and Acquisitions, and Service Diversification to Transform Change, transformation, disruption: whatever you want to call it, it’s happening in the hospice industry over the next 5 years. It is unquestionable that the carve-in to Medicare Advantage, the rise of value-based care and steady market consolidation is changing the playing field. How do hospices respond? In this series, we explore how hospic...

Mar 30, 202245 minEp. 61

Hospice Audit Series: Beyond Part D, OIG Scrutinizes the Hospice Industry to the Tune of $6.6 Billion

Hospice Audit 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 hospice carve-in to Medicare Advantage, MAO audits will join the list. The recent pause in audits as a result of the COVID pandemic hints at increased activity as the pandemic wanes. In this series, Meg Pekarske and Bryan Nowicki of Husch Blackwell’s Hospice Audit team deconstruct ...

Mar 16, 202223 minEp. 60

Hospice Leadership Strategy: Re-engaging Staff and Communities With Story

Welcome to an inspiring conversation on how story can help us reconnect with mission, staff and communities. As hospices face unprecedented staffing shortages and a burnt-out workforce, a key to thriving may be to re-engage with our human essence, which can be found through story. Today’s guest, Dr. Bertice Berry, PhD , explains humans are hardwired for story—it is how we connect, reflect and grow. So how do we use storytelling as a leadership tool? The Institute for Story’s upcoming conference ...

Mar 02, 202246 minEp. 59

Hospice Audit Series: The OIG’s Impending Review of Nationwide Hospice Eligibility Demands a Robust Response From Hospices

Hospice Audit 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 hospice carve-in to Medicare Advantage, MAO audits will join the list. The recent pause in audits as a result of the COVID pandemic hints at increased activity as the pandemic wanes. In this series, Meg Pekarske and Bryan Nowicki of Husch Blackwell’s Hospice Audit team deconstruct ...

Feb 16, 202216 minEp. 58

COVID-19 Hospice How-To Series: Exploring Answers to Hospices’ Top Vaccination Questions

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 they discuss the most pressing vaccination issues and how to navigate them. They explore strategies for handling vendors, the role unvaccinated staff can have in direct patient care, obligations to require boosters and what enforcement may look like. This episode contains many...

Feb 03, 202231 minEp. 57

Who’s Watching Me? Addressing the Second-Guessing of Hospice Patient Care

Providing hospice care to vulnerable individuals can embroil hospices in a variety of unwanted situations. The emotions surrounding the death of a loved one can cause families and caregivers to question the kind of care provided. These sensitive circumstances can also lead to disputes between family members, or between the family and other providers or facilities, with the hospice often stuck in the middle. In this episode, Husch Blackwell’s Meg Pekarske , Bryan Nowicki and Jake Harris discuss w...

Jan 19, 202224 minEp. 56

Beyond Regulations: Hospice Business Contracts and Contract Disputes

Hospices’ unique regulatory and business environment impacts how they contract with and relate to other private entities. In this episode, Husch Blackwell’s Meg Pekarske , Bryan Nowicki and Jake Harris discuss the many kinds of hospice-related contracts and contract-dispute matters they have worked on, and how their clients benefitted from their in-depth knowledge of hospices....

Jan 05, 202227 minEp. 55

Hospices and The False Claims Act: Proposed Amendment Would Increase Liability Risk

Hospices and the False Claims Act Series The False Claims Act (FCA) is the government’s most serious weapon to combat fraud in the healthcare community, and hospices are increasingly the target of FCA investigations and lawsuits. The United States Supreme Court is, for the first time, considering FCA cases involving hospices and certifications of terminal illness. Moreover, the relief funds disbursed by the government to hospices as a result of the COVID-19 pandemic add to the existing and subst...

Dec 15, 202114 minEp. 54

Strategic Restructuring for the Future, Think Before You Sign: Five Key Insights for VBID and Managed Care Contracts

Strategic Restructuring for the Future: Exploring How Hospices Are Using Joint Ventures, Mergers and Acquisitions, and Service Diversification to Transform Change, transformation, disruption: whatever you want to call it, it’s happening in the hospice industry over the next 5 years. It is unquestionable that the carve-in to Medicare Advantage, the rise of value-based care and steady market consolidation is changing the playing field. How do hospices respond? In this series, we explore how hospic...

Dec 01, 202129 minEp. 53

COVID-19 Hospice How-To Series: Federal COVID-19 Vaccine Mandate Rules - Breaking Down What They Mean for Hospices

What is the latest on vaccine mandates? In this episode, Husch Blackwell's Meg Pekarske is joined by colleague Tom O’Day to discuss the newly released OSHA and CMS rules. They'll uncover the surprises, discuss how to implement the requirements and analyze the challenges that may be on the horizon for hospices. Tune in to this lively and helpful conversation....

Nov 11, 202124 minEp. 52

Hospice Audit Series: Insights for Winning at Administrative Law Judge (ALJ) Hearings, Part II

Hospice Audit 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 hospice carve-in to Medicare Advantage, MAO audits will join the list. The recent pause in audits as a result of the COVID pandemic hints at increased activity as the pandemic wanes. In this series, Meg Pekarske and Bryan Nowicki of Husch Blackwell’s Hospice Audit team deconstruct ...

Oct 20, 202128 minEp. 51

Hospice Audit Series: Insights for Winning at Administrative Law Judge (ALJ) Hearings, Part I

Hospice Audit 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 hospice carve-in to Medicare Advantage, MAO audits will join the list. The recent pause in audits as a result of the COVID pandemic hints at increased activity as the pandemic wanes. In this series, Meg Pekarske and Bryan Nowicki of Husch Blackwell’s Hospice Audit team deconstruct ...

Oct 06, 202130 minEp. 50

Drumroll Please: The Latest on HIS Appeals

In this episode, Husch Blackwell's Meg Pekarske chats with colleagues Bryan Nowicki and Jacob Harris , who share what happened with the Hospice Item Set (HIS) noncompliance letters. You have to listen—did hospices win or lose?

Sep 24, 202115 minEp. 49

Strategic Restructuring for the Future, Putting a Plan Into Action: A Conversation With Gloria Brooks on Building End-of-Life Partnerships

Strategic Restructuring for the Future: Exploring How Hospices Are Using Joint Ventures, Mergers and Acquisitions, and Service Diversification to Transform Change, transformation, disruption: whatever you want to call it, it’s happening in the hospice industry over the next 5 years. It is unquestionable that the carve-in to Medicare Advantage, the rise of value-based care and steady market consolidation is changing the playing field. How do hospices respond? In this series, we explore how hospic...

Sep 22, 202158 minEp. 48

Hospice Audit Series: A Beginning and an End from CMS - TPE Resumes While QIC Demonstration Ends

Hospice Audit 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 hospice carve-in to Medicare Advantage, MAO audits will join the list. The recent pause in audits as a result of the COVID pandemic hints at increased activity as the pandemic wanes. In this series, Meg Pekarske and Bryan Nowicki of Husch Blackwell’s Hospice Audit team deconstruct ...

Sep 08, 202116 minEp. 47

Parsing Out Changes in the Election Addendum Made by the Final Hospice Wage Index Rule

By October 1, 2021, hospices will need to update their election addendum form to address a change made by the Centers for Medicare & Medicaid Services (CMS) in the final rule. The government has provided much-needed clarification and flexibility to certain aspects regarding the addendum. When should hospices provide the addendum to patients? What should hospices do if a patient refuses a signer’s discharge prior to signing the addendum? In this episode, Husch Blackwell’s Meg Pekarske and And...

Aug 25, 202126 minEp. 46

Governance Series: Common Board Challenges and Tips for Dealing with Them

After exploring the attributes of a well-functioning board, in this episode we delve into common practices and tendencies that can limit board performance. Whether it be factioning, side conversations or confidentiality leaks, there are activities that get in the way of good governance. Husch Blackwell’s Meg Pekarske and Stephanie Kaiser talk through how to help leaders identify these roadblocks and institute practical strategies to navigate them. We hope you enjoy this insightful conversation f...

Aug 11, 202152 minEp. 45

An Unexpected Flurry: HIS Noncompliance Letters Have Many Scratching Their Heads

In this episode, Husch Blackwell’s Meg Pekarske and Jacob Harris unpack what may be behind the Hospice Item Set (HIS) noncompliance letters that many hospices believe they have erroneously received. These letters indicate hospices have not achieved compliance with the HIS reporting requirement. Meg and Jacob explore how the Centers for Medicare & Medicaid Services’ (CMS) temporary 6-month reporting exemption may have unexpectedly impacted some hospices. They also discuss the importance of us...

Jul 29, 202122 minEp. 44

Staying Prepared: Hospices and the False Claims Act, Part III - Success in False Claims Act Lawsuits

Hospice and the False Claims Act Series The False Claims Act (FCA) is the government’s most serious weapon to combat fraud in the healthcare community, and hospices are increasingly the target of FCA investigations and lawsuits. The United States Supreme Court is, for the first time, considering FCA cases involving hospices and certifications of terminal illness. Moreover, the relief funds disbursed by the government to hospices as a result of the COVID-19 pandemic add to the existing and substa...

Jul 14, 202146 minEp. 43
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