Our podcast series features AGG attorneys and guests discussing business opportunities and legal issues for our friends in the home health and hospice industries. While we don’t provide care, we nevertheless consider ourselves part of the home health and hospice community. We enjoy sharing what we’ve learned after working with clients throughout the country, as well as giving our thoughts on new opportunities and challenges facing the industry, whether regulatory, reimbursement, compliance, or otherwise.
Anti-Kickback Compliance for Hospice and Skilled Nursing Providers
In this episode, AGG Healthcare attorneys Bill Dombi and Jason Bring discuss recent OIG guidance on hospice and skilled nursing facility relationships, focusing on anti-kickback risks and fraud concerns. They cover key issues such as the importance of documenting fair market value for any services or space provided, being cautious of payments exceeding Medicaid room and board rates, and avoiding arrangements that appear to be made solely to secure referrals. Bill and Jason also touch on incre...
4 Mar 2025
The Impact of AI and Prior Authorizations on Home Health and Hospice
In this episode, AGG Healthcare attorneys Bill Dombi and Jason Bring discuss the role of managed care, artificial intelligence, and prior authorizations in home health and hospice. Bill and Jason examine a recent lawsuit filed against a major Medicare Advantage plan in the United States District Court for the District of Minnesota challenging the use of AI-driven claims reviews in Medicare Advantage coverage decisions. They also address concerns around prior authorization denials, their high ...
18 Feb 2025
Hospice Special Focus Program: Pumping the Brakes
In this episode, AGG Healthcare attorneys Bill Dombi and Jason Bring discuss the hospice special focus program and CMS’ announcement that it will cease implementing the program in the face of litigation filed by providers and state associations.
2 Dec 2024
OIG Report Reveals Gaps in Hospice PRF Compliance: What Providers Need to Know
AGG Post-Acute & Long-Term Care co-chair Jason Bring and AGG Healthcare partner Alex Foster break down the OIG report's findings on hospice PRF compliance, providing practical steps to prepare for audits and ensure regulatory compliance.
23 Oct 2024
Navigating the Audit Maze: Insights From Northeast Georgia Health System
In this episode, AGG Post-Acute & Long-Term Care co-chair Jason Bring is joined by Kathy Barton and Natalie McNeal of Northeast Georgia Health System. Kathy and Natalie share insights on navigating the complexities of hospice audits, discuss their experiences with the appeal process, and offer practical strategies for success. They also delve into lessons learned, the importance of thorough documentation, and how to effectively prepare for administrative hearings.
11 Jul 2024
Understanding Palliative Care: Strategies for Compliance and Reimbursement
In this episode, AGG Post-Acute & Long-Term Care co-chair Jason Bring (https://www.agg.com/professionals/jason-bring/) is joined by AGG Healthcare attorney Charmaine Mech Aguirre (https://www.agg.com/professionals/charmaine-mech-aguirre/) to discuss the latest developments in the palliative care industry across the country. Jason and Charmaine talk through the key differences between hospice and palliative care, various models and approaches providers are adopting, and regulatory and reimbursement challenges. From state licensure requirements to compliance with the Anti-Kickback Statute, they provide valuable insights and practical advice for providers looking to expand or refine their palliative care services.
11 Jun 2024
Lessons Learned From ALJ Hospice Audit Appeals
In this episode, AGG Post-Acute & Long-Term Care co-chair Jason Bring (https://www.agg.com/professionals/jason-bring/) is joined by Megan Turby (https://www.linkedin.com/in/megan-turby-weaver-m-s-ed-chc-cphq-26298484/) and Lisa Barker (https://www.linkedin.com/in/dr-lisa-barker-4841409a/), MD, of Gulfside Healthcare Services in Land O' Lakes, Florida. AGG represented Gulfside in a series of hospice audit appeals before multiple administrative law judges ("ALJs"). Megan and Dr. Barker share their experiences in the ALJ hearings, as well as lessons learned. Their discussion also emphasizes how to prepare for hearings and prevent denials from the outset.
14 Jul 2023
Home Health and Hospice: Reimbursement Audits and Appeals
In this episode, Jason Bring (https://www.agg.com/professionals/jason-bring/), AGG Healthcare partner and co-chair of the Post-Acute & Long-Term Care team, and Lanchi Nguyen Bombalier (https://www.agg.com/professionals/lanchi-bombalier/), AGG Healthcare partner and member of the Post-Acute & Long-Term Care, Hospitals & Health Systems, and Healthcare Private Equity industry teams, discuss “Home Health and Hospice: Reimbursement Audits and Appeals.” Jason and Lanchi provide a high-level overview of the audit environment and how to better prepare and navigate the process.
21 Mar 2023
Home Health and Hospice Diligence
In this episode, Jason Bring (https://www.agg.com/professionals/jason-bring/), AGG Healthcare partner and co-chair of the Post-Acute & Long-Term Care team; Alex Foster (https://www.agg.com/professionals/alexander-foster/), AGG Healthcare partner and member of the Post-Acute & Long-Term Care and Private Equity teams; and Charmaine Mech (https://www.agg.com/professionals/charmaine-mech/), AGG Healthcare associate and member of the Post-Acute & Long-Term Care team, discuss “Home Health and Hospice Diligence,” where Alex and Charmaine provide a high-level overview of the healthcare regulatory diligence performed in acquisitions as well as nuances buyers and sellers should be aware of in the home health and hospice space.
16 Feb 2023
Home Health and Hospice Deal Environment
In this episode, Jason Bring (https://www.agg.com/professionals/jason-bring/), AGG Healthcare partner and co-chair of the Post-Acute & Long-Term Care industry team; Matt Brohm (https://www.agg.com/professionals/matthew-brohm/), AGG Healthcare partner and co-chair of the Healthcare Private Equity team; and Alex Foster (https://www.agg.com/professionals/alexander-foster/), AGG Healthcare partner, discuss the macro environment for deals involving care at home, as well as some of the legal and business issues we see cropping up in deals — some good and some bad.
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