KANSAS CITY, Missouri— Husch Blackwell’s Hospice practice team handled a record number of hospice audits during 2022, part of a surge in audits witnessed by the industry, the company said. Attorneys at Husch Blackwell worked on more than 200 audit matters for hospices throughout 2022, a number the group anticipates will remain steady or potentially increase in the coming year.
audits
BIRMINGHAM, Alabama (November 11, 2022)—The Centers for Medicare & Medicaid Services (CMS) has published a clarification regarding medical review audits after the public health emergency (PHE) ends. This is the first public guidance CMS has published regarding audits aft
Training can help prevent future issues
Get your team ready for a possible feeding frenzy
WASHINGTON, D.C. (February 22, 2022)—Medicare paid a total $6.6 billion to nonhospice providers for services provided to hospice beneficiaries between 2010 and 2019, according to a new report from the U.S. Department of Health & Human Services Office of the Inspector General (OIG).
WASHINGTON, D.C. (December 17, 2021)—On November 16, Department of Health and Human Services Office of Inspector General (OIG) published the report titled, “Medicare Improperly Paid Suppliers an Estimated $117 Million Over 4 Years for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Provided to Hospice Beneficiaries.”
ATLANTA (November 23, 2021)—PruittHealth, Inc. and affiliated entities have agreed to pay $4.2 million to resolve allegations that they submitted claims for home health services that were not covered by the Medicare and Medicaid programs, and that they failed to refund overpayments that they had received from Medicare and Medicaid in a timely manner.
WASHINGTON, D.C. (October 5, 2021)—An audit of eight home health agencies (HHAs) by the Department of Health and Human Services Office of the Inspector General (OIG) found that most had infection control policies and procedures that met the standards set by the Centers for Medicare & Medicaid Services (CMS) and followed CMS COVID-19 guidance to safeguard Medicare beneficiaries, caregivers, and staff during the coronavirus pandemic, according to a report issued last week.
WASHINGTON, D.C. (September 7, 2021)—The Centers for Medicare & Medicaid Services (CMS) indicated in an August 2021 MLNConnects newsletter that the agency will resume the targeted probe and educate (TPE) program that was suspended in March 2020 (as were most medical reviews) due to the COVID-19 public health emergency (PHE).
Some medical reviews resumed in August 2020, despite the PHE, but the TPE program remained on pause.
PHOENIX, Arizona (July 13, 2021)—A number of legal and government entities will be hunting for fraud around COVID-19 relief programs, and the health care sector—the largest recipient of first-draw Paycheck Protection Program (PPP) loans—is dead in their sights.
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Audit advice & 4 strategies for success
MADISON, Wis. (February 23, 2021)—Husch Blackwell’s Hospice & Palliative Care team secured a $44 million reduction of an alleged overpayment for a hospice client involved in an audit of Medicare payments. The auditor, a contractor hired by the Centers for Medicare & Medicaid Service (CMS) to audit hospices, had used statistical extrapolation to find this extraordinary overpayment amount.
Handling HIPAA violation complaints
WASHINGTON, D.C. (October 7, 2020)—The Department of Health and Human Services (HHS) opened the $20 billion Phase 3 General Distribution under the Provider Relief Fund (PRF) on Monday, Oct.5th.
WASHINGTON, D.C. (September 18, 2020)—The Office of Inspector General (OIG) of the Department of Health and Human Services conducted an audit to determine whether the Centers for Medicare & Medicaid Services (CMS) ensured that MACs and QICs reviewed appealed extrapolated overpayments consistently and in a manner that conforms with existing CMS requirements.
WASHINGTON, D.C. (July 24, 2020)—The Centers for Medicare & Medicaid Services (CMS) could have saved $192 million by targeting home health claims for review with visits slightly above the threshold that triggers a higher Medicare payment, according to a new report from the Office of Inspector General (OIG) of the Department of Health & Human Services.
WASHINGTON, D.C. (July 22, 2020)—The Centers for Medicare & Medicaid Services (CMS) recently announced in the Coronavirus Disease 2019 (COVID-19) Provider Burden Relief Frequently Asked Questions (FAQs) that the suspension of Medicare fee for server (FFS) audits due to the COVID-19 public health emergency will be lifted beginning Aug. 3, 2020 (see page 1).