Hospice Insights: The Law and Beyond
Health, Fitness & Longevity
About
Tune in to Husch Blackwell’s hospice podcast with Bryan Nowicki 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.
Episodes
- Hospice Audit Updates: UPICs May Pick You for a Prepayment Review
Hospice providers are experiencing a rise in audits, including prepayment reviews by Unified Program Integrity Contractors (UPICs). This episode discusses the new UPIC audit type and its implications for hospices.
- High Risk Hospices Are in the Hot Seat Across Six States
CMS prepayment reviews, known as EPRs, are now targeting hospice providers in six states: Arizona, California, Nevada, Texas, Georgia, and Ohio. Husch Blackwell attorneys Bryan Nowicki and Zaina Niles explain the EPR process and how hospic…
- What’s New? CMS Provisional Period of Enhanced Oversight Application to “New” Hospices
CMS has expanded its Provisional Period of Enhanced Oversight (PPEO) to new hospice providers in Arizona, California, Nevada, Texas, Georgia, and Ohio. Attorneys Bryan Nowicki and Adam Royal from Husch Blackwell explain how these regulator…
- PPEO Playbook: The High-Stakes Game Hospices Can’t Afford to Lose
This episode features Claire Postman and host Bryan Nowicki discussing the CMS provisional period of enhanced oversight (PPEO) program. They cover who is affected, what the program entails, and strategies for hospices to manage or prevent…
- Endings and Beginnings: Reflections on Meg Pekarske’s 25+ Years as a Hospice Advocate
Meg Pekarske, a hospice attorney, shares reflections on her 25+ years advocating for the hospice community with host Bryan Nowicki. The discussion covers the attributes of effective hospices and leaders, contemporary challenges, and a hope…
- Reimagining How We Navigate Change and Loss: A Conversation with Sonya Dolan and Bridget Sumser of Mettle Health
In Meg Pekarske's final Hospice Insights episode, she speaks with Mettle Health co-founder Sonya Dolan and counselor Bridget Sumser about their work supporting individuals through change and loss. The conversation covers Mettle Health's mo…
- Hospital to Hospice: Managing Referrals and Relationships
Husch Blackwell's Meg Pekarske and Bryan Nowicki discuss common referral scenarios from hospitals to hospice, addressing hospice eligibility, care levels, and expectations for patients and hospitals. Resources on general inpatient care are…
- But Am I Set Up for Growth: Corporate and Governance Considerations for Growing Hospices
Many hospices established their single entity corporate structure 40+ years ago and have left it largely untouched. But this too is worth a dust off especially as hospices are expanding into new geographies, new service lines, and affiliat…
- If Only I Knew… Avoiding the Most Common Mistakes with the 855
The world of Medicare enrollment and the 855 may seem like a tangle of boring paperwork, but all that i-dotting and t-crossing is critical for avoiding Medicare deactivation and other unpleasant consequences. In this episode, Husch Blackwe…
- Making Palliative Care a Win-Win-Win: A Conversation with Dr. Bethany Snider, Chief Medical Officer, Hosparus Health
You know those conversations that leave you feeling excited, hopeful, and ready to change the world? This is one of those conversations. In this episode, Husch Blackwell’s Meg Pekarske is joined by American Academy of Hospice and Palliativ…
- Let’s Face (to Face) It: Important Changes to Hospice Face-to-Face Attestation Requirements and Other Tidbits from the 2026 Hospice Final Rule
CMS’s FY 2026 hospice final rule introduces significant changes to the face-to-face (F2F) attestation requirements starting October 1, 2025. All in all, the news is positive: while there is a new requirement for the F2F attestation to be s…
- Where’s the Line: When Does Poor Quality Create False Claims Liability
Substandard quality care is the subject of survey citations and lawsuits, but it has also been used by the Justice Department to support false claim liability. While historically these cases were rare, a recent multi-million dollar settlem…
- Hospice Audit Updates: Hospices Fare Well in Federal Court
Increasing audit activity combined with certain decreasingly favorable audit appeal outcomes has resulted in hospices appealing audit results beyond the administrative law judge phase and into federal court. In this episode, Husch Blackwel…
- AI in Action: Exploring How AI Is Helping Hospices Do Things in New Ways
Husch Blackwell’s Meg Pekarske is joined by Dina Yankelewitz, CEO of Vitalis Care, a technology company that is harnessing AI technology to reduce staff burden and allow more time for patient care. Dina shares her vision and passion for th…
- Election Inspection: Be Proactive to Avoid Costly Election Statement Denials
In an audit, election statement deficiencies can be costly. Auditors deny all claims covered by the problematic election statement, and those costs can multiply if more than one patient was affected. In this episode, Husch Blackwell’s Meg…
- Still Number One: Healthcare Fraud Remains Central in DOJ’s White Collar Enforcement Plan
On May 12, 2025, the Head of the Criminal Division for the Department of Justice (DOJ) issued a memorandum outlining its enforcement priorities. In this episode, Husch Blackwell’s Meg Pekarske and Jonathan Porter break down what is new and…
- Hospice Audit Updates: David Beats Goliath
Hospice audits can have profound financial implications, particularly when the auditors use statistical extrapolation to identify an overpayment amount. The use of extrapolation runs across auditor types, including UPICs and the OIG, and c…
- But Wait: Things to Consider Before Adopting AI Tools In Your Hospice
Husch Blackwell’s Meg Pekarske is joined by colleague Kathleen Snyder , who has extensive experience in digital health and has been busy advising health care providers on how to safely implement artificial intelligence (AI) tools in their…
- One Size Doesn’t Fit All: Figuring Out What is Your Hospice+
For hospices, unprecedented competition, enhanced oversight, and looming payment reform create business obstacles or growth opportunities, depending on your outlook. Your growth strategy shouldn’t be the same as your neighbor’s. Instead of…
- Psychedelics and End of Life Care: Understanding the Legal Landscape
There has been a lot of buzz around psychedelics and particularly their potential usefulness in treating existential suffering at the end of life. Husch Blackwell was the first law firm in the country to establish a Psychedelics & Emerging…
- Controlling the Narrative: A New Tactic for Auditors and ALJs
Hospices that have gone through audits are familiar with certain recurring reasons why auditors deny claims. Two common reasons are the lack of support for a six-month prognosis and the insufficiency of the physician narrative. In this epi…
- Upping the Ante: Will CMS’s Enhanced Oversight Efforts Cause Hospices to Fold?
CMS recently expanded its Provisional Period of Enhanced Oversight, or PPEO, in Arizona, California, Nevada, and Texas, and its enforcement activities nationwide appear more aggressive. In this episode, Husch Blackwell’s Meg Pekarske and B…
- A Year in Review: Reflections and Hopes for the Future
It’s our first podcast of 2025 and we wanted to start the year out with some reflections. Join Husch Blackwell’s Meg Pekarske and Bryan Nowicki as they each share their biggest surprises and victories of 2024 and what is on their wish list…
- What a Difference No Deference Makes: Courts No Longer Bow to Administrative Agencies
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, in…
- Meet the New Laws, Same as the Old Laws: Overpayment Recoupment Update
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 upd…
- What’s Good and Bad in Hospice Right Now: A Conversation with Greg Grabowski, Partner at Hospice Advisors
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 worl…
- What’s the Latest on UPICs? Highlights From Recent Audit Activity, Part II
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…
- What’s the Latest on UPICs? Highlights From Recent Audit Activity, Part I
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, pa…
- Stories of Successful Hospice Leadership: The CEO and Chief Medical Officer Relationship
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,…
- A Rise in Medicare Deactivations: Tips for Avoiding This Financial Pain
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…
- Check the Mail: Are You Getting a 4% Rate Cut?
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 Jac…
- Hospice Labor and Employment Trends - Get Up to Speed Fast: What You Need to Know About the New Rules Involving Non-Competes and Exempt Employees
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 co…
- A Refresh: What’s New in the New OIG General Compliance Program Guidance
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 jo…
- Deal Breakers: Identifying Key Issues Early in Member Substitutions
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—a…
- An Ounce of Prevention: Keys to Understanding and Preventing AI and Cybersecurity Risks
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. J…
- A Command Performant(s): RAC Audits on the Rise
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 ta…
- The TPE Carousel. . . Around and Around We Go
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 Nowic…
- A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
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 M…
- OMG. . .The OIG is at it Again
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 hospi…
- How One Hospice Owner Got Convicted of Healthcare Fraud and How You Can Avoid That Fate
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…
- Hospice and Home Health Survey Perspectives: A Conversation with Kim Skehan, VP of Accreditation at CHAP
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…
- Year in Review: Key Regulatory Updates in 2023
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.
- An Alternative to Consolidations: Key Considerations for Management Services Organizations
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 epi…
- Stories of Successful Hospice Leadership: The CEO and Compliance Officer Relationship
An effective compliance program is the bedrock of any successful healthcare organization and behind every successful compliance program is a trusted relationship between the Compliance Officer and CEO. In this episode, Husch Blackwell’s Me…
- A Very “Special” Episode: Amid Controversy, CMS Launches the Hospice Special Focus Program
Centers for Medicare & Medicaid Services (CMS) devised a “Special Focus Program” to identify poor performing hospices and help them improve through more frequent surveys and technical assistance. CMS would also impose enforcement remedies…
- Grace from CMS: Unexpected Good News on HIS and CAHPS Appeals
For a variety of unfortunate reasons, some hospices found themselves facing a 4% rate reduction for non-compliance with either Hospice Item Set (HIS) or Consumer Assessment of Healthcare Providers & Systems (CAHPS) requirements. For the th…
- This Bandwagon Has a Broken Wheel: OIG Joins the Inconsistent Approach to Hospice GIP Claims
CMS has criticized hospices for underutilizing general inpatient care (GIP) but has also specifically targeted GIP claims for audit and medical review. In addition to CMS’s standard tools for reviewing GIP claims, such as UPIC audits and T…
- A Significant Departure: Unpacking What the New Antitrust Guidelines Mean for Healthcare Providers
Join Husch Blackwell’s Meg Pekarske and Wendy Arends as they explore the new draft Merger Guidelines and what enforcement may look like in the future. Given the number of hospices looking to consolidate through mergers, joint ventures, and…
- The Gift That Keeps On Giving: TPE Insights and Strategies
While not new, the number and scope of Targeted Probe and Educate (TPE) reviews have soared to new heights. At the same time, more hospices are facing the uncomfortable position of moving to a second and sometimes third round of review. In…
- Behind the Curtain: Enhanced Provider Enrollment Oversight
In the midst of consolidation and restructuring among hospices, the Centers for Medicare & Medicaid Services (CMS) is scrutinizing initial enrollments and changes in ownership and management. In this episode, Husch Blackwell’s Meg Pekarske…