24 02, 2017

Proof by Proxy in FCA Suits? District Court Says It Depends

By | February 24th, 2017|Comments Off on Proof by Proxy in FCA Suits? District Court Says It Depends

Admissibility of statistical sampling to prove liability in FCA suit is fact dependent. In a February 14, 2017 decision, the Fourth Circuit declined to rule on the question of whether statistical sampling can be used to prove liability and damages in False Claims Act (FCA) lawsuits, concluding that it should not have agreed to [...]

1 04, 2016

False Claims Act Trial Sets Precedent for Future Cases

By | April 1st, 2016|Comments Off on False Claims Act Trial Sets Precedent for Future Cases

The DOJ’s theory of falsity based on clinical disagreement alone fails as a matter of law. In a closely watched False Claims Act (FCA) proceeding by the healthcare industry and FCA practitioners, the US District Court for the Northern District of Alabama ruled in favor of a national hospice provider and dismissed the action, rejecting [...]

15 01, 2015

OIG Recommends Greater Scrutiny for Hospice Services Furnished to Patients in ALFs

By | January 15th, 2015|Comments Off on OIG Recommends Greater Scrutiny for Hospice Services Furnished to Patients in ALFs

The evaluation and policy division of the HHS Office of Inspector General (OIG) issued a study dated January 13, 2015 after evaluating all Medicare hospice claims from 2007 through 2012.  If history is a guide, critical OIG studies such as this one trigger additional targeted scrutiny, and so hospices, particularly for-profit hospices, should expect increased hospice audits related to their services to ALF residents. 

17 12, 2014

Part II. Appreciative Inquiry and the Certification Process…Imagine That! Discovery and Dream

By | December 17th, 2014|1 Comment

Years of experience and research have demonstrated that “…people learn, and organizations change most readily when they focus on, study, and engage in dialogue about strengths, patterns of success and who they are at their best."

17 12, 2014

Part III. Appreciative Inquiry and the Certification Process…Imagine That! Design and Destiny

By | December 17th, 2014|Comments Off on Part III. Appreciative Inquiry and the Certification Process…Imagine That! Design and Destiny

Through collaborative thinking, the team chooses innovative processes that are in alignment with both the strengths identified in Discovery and the imagined hopes of the future (Dream).  

30 10, 2014

In Hospice, Every Day is Election Day

By | October 30th, 2014|Comments Off on In Hospice, Every Day is Election Day

What does hospice have in common with political campaigns besides elections? Unfortunately, more than you'd think. It's not to late to reverse course and return to the days when journalists, patients/families, and referring physicians were promoting the benefits of hospice. Our colleague Kathy Brandt explores these similarities and ways each hospice can work to repair the reputation of hospice.

20 10, 2014

Back to the “Definition Board:” Defining Terminal Illness

By | October 20th, 2014|1 Comment

The Medicare Hospice Benefit has always defined the terminal illness, not as a single diagnosis, but as the interplay of conditions that together cause an individual to have a prognosis of 6 months or less.  At this point, the proposed definition is open for comments. However, my guess is that in the final determination there may well be a clear differentiation between the definition of ‘terminal illness’ and that of the ‘principle/hospice-qualifying diagnosis’ to better underscore the prognostic implication and comprehensive nature of the former.

25 09, 2014

Keep Calm…and Prepare for IMPACT – Part 1

By | September 25th, 2014|Comments Off on Keep Calm…and Prepare for IMPACT – Part 1

The passage of the 2014 IMPACT Act will bring more survey's to hospices. In this first of two blog posts, Joy Barry details what hospices need to do now to prepare for more frequent surveys of a hospice’s compliance with the Medicare Conditions of Participation (CoPs).

21 09, 2014

Will the Impact Act really help the hospice industry?

By | September 21st, 2014|2 Comments

Am I a party pooper?  A Debbie Downer? You can decide, but I don't think the hospice provisions in the Impact Act of 2014 are going to do much to increase transparency, sort out the "good"  hospices from the "bad," or, sadly, improve the quality of care provided by hospices. Let me explain...