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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 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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COVID-19 has affected all aspects of hospice care, operations and personnel, including the person whose judgment is at the center of the Medicare hospice benefit: the hospice physician. In this episode of Hospice Insights, we discuss the increased significance of, and scrutiny applied to, hospice physicians in the age of COVID-19, and identify potential traps

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Consistent with NHPCO’s recent regulatory guidance, you may have received an unexpected payment on or about Friday, April 10th via Optum Bank with “HHSPAYMENT” as the payment description. That payment was from the Public Health and Social Services Emergency Fund (“Relief Fund”) which was set up pursuant to the CARES Act to provide $100 billion of relief funding to healthcare providers. The payment received is from the first $30 billion of the total $100 billion Relief Fund. The payment is not a loan; it is a grant that the hospice can use for qualified expenses and losses that meet a series of Terms and Conditions.

Change is fast-paced in the world of COVID-19. On Monday, March 30th, CMS released an interim final rule along with hospice specific waivers. In this episode, your Hospice Team discusses these recent developments and their impact on telehealth, face-to-face encounters, virtual visits and Medicare appeals and audits.

For resources related to this episode, please

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In this episode, your Hospice Team shares insights on operationalizing recent government guidance for hospices facing coronavirus obstacles. We discuss the role of virtual visits, how to use telehealth, and the practical impact of the Medicare appeal waiver. Listen to the full episode here: https://bit.ly/2JmhkMV

On March 22, 2020, and as subsequently clarified on March 27, 2020, the Centers for Medicare and Medicaid Services (“CMS”) temporarily lifted the requirements for hospices to submit Hospice Item Set (“HIS”) data and hospice Consumer Assessment of Healthcare Providers and Systems (“CAHPS”) survey data.  Prior to CMS’s action, failure to comply with these data reporting requirements of the Hospice Quality Reporting Program (“HQRP”), absent an exception, resulted in a 2 percent reduction to a hospice’s annual Medicare payment update.

Telehealth

The Husch Blackwell Hospice Team has been receiving reports from hospices throughout the country that nursing facilities are prohibiting hospice workers from entering the facility to provide essential end-of-life care to hospice patients. Such access is being denied pursuant to visitor restrictions. However, hospice personnel are not visitors but are recognized by the Centers for Medicare and Medicaid Services (“CMS”) as essential health care personnel who must be given access.

These are extraordinary times. COVID-19, or the novel coronavirus, has disrupted the life of every American and every business. Hospices are no exception. In fact, they are on the frontlines, responsible for providing care to the elderly, a population extremely susceptible to COVID-19. The Husch Blackwell Hospice Team is fundamentally a group of problem solvers,…

In this “Hospice Insights: The Law and Beyond” episode, the hospice team shares insights on how to manage and succeed in responding to additional documentation requests (“ADR”) stemming from Targeted Probe and Educate (“TPEs”) projects. We discuss the unique features of TPE and winning strategies for responding. Check out the Hospice Resource Library for tips…