Hospice Contracted Services

Recorded On: 06/19/2019

Government attention to hospice contractual relationships has evolved beyond surveys of the Medicare Conditions of Participation (CoPs). In light of concerns about whether hospices are covering all services related to the terminal illness, auditors and data analytics are being used to evaluate hospice relationships such as those with DME companies, hospitals, and pharmacies for potential overpayments. This means hospices need to understand how contracts impact their professional management responsibilities, the hospice conditions of payment, and the anti-kickback statute. In this session, the presenters will use their experience creating industry-trusted contracting resources and day-to-day work with hospices to help you identify and address common challenges in a variety of hospice contracts, from facilities to pharmacies, and prepare for emerging business and policy issues.

Topics covered in this webinar include:

  • How to prioritize and reconcile the competing business, operations, and compliance issues that are affected by contracts
  • Key considerations to help hospices evaluate the feasibility and reasonability of the arrangement
  • Potential reimbursement ramifications related to hospice contracts
  • Contractual provisions that help address key compliance risk areas such as the federal anti-kickback statute and OIG exclusion
  • Federal hospice regulatory requirements for facility and vendor contracts
  • Strategies for addressing potential compliance issues such as improper billing for services related to the terminal illness

Meg S.L. Pekarske

Shareholder

As chair of Reinhart’s Hospice and Palliative Care Practice Group, Meg leads a team of seven who are devoted to serving the ever-changing legal needs of the hospice industry.  Working with hospices across the country as well as national and state hospice associations, Meg and her team are intimately familiar with the operational challenges of hospices and have the experience to address the full spectrum of legal issues facing the industry, from routine regulatory compliance issues, internal investigations, repayments, to all types of government audits.  

Meg is very results-driven.  In the past year, she and her team have successfully defended countless audits, winning over $80 million dollars for hospices. 

Meg was recently honored as a 2016 "Woman in the Law" by the Wisconsin Law Journal. This annual award honors outstanding achievement by the top Wisconsin women in the practice of law.  She has also been selected as a Super Lawyer and Best Lawyer in America.

Karla Pinkerton

Associate

Karla Hutton Pinkerton is an attorney in Reinhart’s Health Care Practice where she primarily works with the Hospice and Palliative Care Practice Group. She has experience working with clients involved in a wide range of hospice-related matters from day-to-day regulatory and contracting issues to assisting in a variety of audit appeals. Karla also frequently assists hospices in evaluating complex repayment and compliance matters.

With a Master’s in Public Health and a law degree with a certificate in health law, Karla brings an understanding of the complexities surrounding the provision, payment and regulation of health care. Through personal experience and her time at Reinhart, Karla has gained an understanding and appreciation of hospice operations and is dedicated to offering creative solutions to an array of legal and compliance matters.

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