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Hospice Audit Series: The Second Guessing of Billed Hospice Physician Visits

By Former Attorney Meg Pekarske, Bryan K. Nowicki & Erin E. Burns on April 14, 2021
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Hospice Insights

In today’s episode of Hospice Insights: The Law and Beyond, Husch Blackwell’s Meg Pekarske is joined by colleagues Bryan Nowicki and Erin Burns to discuss the recent denial of physician visits. Over the last several months, a number of auditors have begun questioning the medical necessity of billed physician visits, claiming the physician services were solely administrative in nature. They break down the criteria auditors appear to be using, what this means for hospices and how hospices can avoid such denials. We hope you enjoy the conversation: https://bit.ly/3wUGeus

Photo of Former Attorney Meg Pekarske Former Attorney Meg Pekarske

Meg devoted her legal practice to serving the everchanging legal needs of the hospice industry. Previously with Husch Blackwell, Meg was the former chair of Husch Blackwell’s Hospice and Palliative Care Practice Group and she managed the firm’s hospice practice. 

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Photo of Bryan K. Nowicki Bryan K. Nowicki

I lead the litigation and internal investigation efforts within Husch Blackwell’s Hospice and Palliative Care Practice Group. I work with hospices and healthcare providers across the country on a range of litigation, regulatory, compliance, and business matters. I represent clients in False Claims…

I lead the litigation and internal investigation efforts within Husch Blackwell’s Hospice and Palliative Care Practice Group. I work with hospices and healthcare providers across the country on a range of litigation, regulatory, compliance, and business matters. I represent clients in False Claims Act lawsuits, state and federal government fraud investigations, and audits by Zone Program Integrity Contractors (ZPICs), Medicare Administrative Contractors (MACs), and Medicaid Integrity Contractors (MICs). I also conduct and manage internal investigations of hospices and health care providers regarding a range of compliance matters.

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Photo of Erin E. Burns Erin E. Burns

Erin is a member of the firm’s Hospice & Palliative Care Team, which collectively has over 25 years of experience working with hospice and palliative care providers across the country. Erin is dedicated to working collaboratively with clients to address their needs…

Erin is a member of the firm’s Hospice & Palliative Care Team, which collectively has over 25 years of experience working with hospice and palliative care providers across the country. Erin is dedicated to working collaboratively with clients to address their needs in an ever-changing, highly regulated industry. Her practice ranges from providing quick answers to immediate day-to-day operational questions to larger, more complex compliance issues. Erin and the Hospice & Palliative Care Team routinely guide hospice providers throughout all phases of government surveys, from strategizing and preparing plans of correction to interfacing with surveyors, as well as audits, including analysis of and response to alleged clinical, technical and statistical errors.

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  • Posted in:
    Health Care and Life Sciences
  • Blog:
    Healthcare Law Insights
  • Organization:
    Husch Blackwell LLP
  • Article: View Original Source

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