AGG Talks: Home Health & Hospice Podcast - Episode 9: The Impact of AI and Prior Authorizations on Home Health and Hospice
AGG Talks: Home Health & Hospice Podcast - Episode 8: Hospice Special Focus Program: Pumping the Brakes
AGG Talks: Home Health & Hospice Podcast - Episode 7: OIG Report Reveals Gaps in Hospice PRF Compliance: What Providers Need to Know
AGG Talks: Home Health & Hospice Podcast - Episode 6: Navigating the Audit Maze: Insights From Northeast Georgia Health System
Hospice Insights Podcast - What's Good and Bad in Hospice Right Now: A Conversation with Greg Grabowski, Partner at Hospice Advisors
Hospice Insights Podcast - What's the Latest on UPICs? Highlights From Recent Audit Activity, Part II
Hospice Insights Podcast: What’s the Latest on UPICs? Highlights from Recent Audit Activity, Part I
Hospice Insights Podcast - Stories of Successful Hospice Leadership: The CEO and Chief Medical Officer Relationship
Hospice Insights Podcast - A Rise in Medicare Deactivations: Tips for Avoiding This Financial Pain
AGG Talks: Home Health & Hospice Podcast - Episode 5: Understanding Palliative Care: Strategies for Compliance and Reimbursement
Hospice Insights: Check the Mail: Are You Getting a 4% Rate Cut?
Hospice Labor and Employment Trends - Get Up to Speed Fast: What You Need to Know About the New Rules Involving Non-Competes and Exempt Employees
Hospice Insights Podcast - A Refresh: What’s New in the New OIG General Compliance Program Guidance
Hospice Insights Podcast - Deal Breakers: Identifying Key Issues Early in Member Substitutions
A Command Performant(s): RAC Audits on the Rise
The TPE Carousel. . . Around and Around We Go
Hospice and Home Health Survey Perspectives: A Conversation with Kim Skehan, VP of Accreditation at CHAP
Year in Review: Key Regulatory Updates in 2023
Episode 172: Matthew Roberts and Lauren DeMoss, Maynard Nexsen Health Care Attorneys
An Alternative to Consolidations: Key Considerations for Management Services Organizations
Grounded in the OIG’s General Compliance Program Guidance and DOJ’s Evaluation of Corporate Compliance Programs, our immersive, three-and-a-half-day, classroom-style Healthcare Basic Compliance Academy equips compliance...more
On April 14, 2025, a federal jury in Nevada convicted a home healthcare nursing executive on one count of conspiracy to fix wages and five counts of wire fraud after a 15-day trial. The verdict represents the DOJ’s first...more
Home Health Care Company to Pay $3 Million to Resolve FCA Allegations - The US Department of Justice (DOJ) announced that Saad Enterprises Incorporated, operating as Saad Healthcare, agreed to pay $3 million to resolve...more
News Briefs - Lawmakers Strike Deal to Extend Expiring Healthcare Programs - Lawmakers reached a deal to extend expiring healthcare programs, lobbyists close to the issue said. The package is more robust than lobbyists...more
Looking for a simple, easy-to-implement way to lower your risk of overpayments? We have one on this week’s podcast!...more
Certain Medicaid programs impose a transfer penalty on applicants who have transferred resources (assets) for less than fair market value within five (5) years preceding the Medicaid application. Simply stated, the transfer...more
Below is Part II of our New Jersey Statutory update. As you can see from the below, several statutes were passed imposing requirements on health insurance payers, including new requirements for prior authorization request and...more
Introduction - Polsinelli proudly introduces the Health Care Fraud and Abuse 2023 Year in Review, a comprehensive examination of the evolving landscape surrounding the False Claims Act (“FCA”) and fraud & abuse enforcement...more
Medicaid is a joint federal and state program that provides health coverage to millions of Americans. Federal law requires states to comply with certain minimum requirements, but New York is considered a maximum state in that...more
Governor Newsom signed 890 bills and vetoed 156 bills in 2023. Every year, California passes multiple laws that impact health care practitioners and health facilities and, as further described below, 2023 is no exception....more
On June 6, 2023, the Center for Medicare and Medicaid Services (CMS) provided a Quality Safety & Oversight (QSO) memorandum outlining CMS-identified concerns with respect to the patient discharge process (Memo). As set forth...more
At the onset of the COVID-19 PHE, CMS was permitted to issue several temporary emergency statutory and regulatory waivers to help providers appropriately respond to the pandemic. On May 1, 2023, the Secretary released a memo...more
AGG’s Home Health & Hospice team publishes a quarterly newsletter covering legal and regulatory topics specific to the home and community-based healthcare industry. The fields of end-of-life and home healthcare present...more
Effective January 1, 2023, The Joint Commission (TJC) eliminated 168 (or 14%) of its accreditation standards across all of its accreditation programs and revised 14 other standards. To further streamline its standards, TJC is...more
CT magazine (October 2022) - The frailty syndrome is an emerging concept for providers who care for individuals with significant comorbidities, advanced age, or a decline in functional or cognitive status; the more...more
Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us virtually at HCCA’s Annual Healthcare Enforcement Compliance...more
The Supplemental Medical Review Contractor (“SMRC”) is a Centers for Medicare and Medicaid Services (“CMS”) contractor authorized to conduct nationwide medical reviews (Medicare Part A, Part B, and DME). As many in the...more
Report on Medicare Compliance 30, no. 8 (March 1, 2021) - According to a CMS spokesperson, “CMS has not yet determined when Targeted Probe and Educate reviews will resume.” Meanwhile, “CMS continues to temporarily pause...more
On December 23, 2020, the OIG published Advisory Opinion 20-06, concluding that it would not impose penalties or sanctions under either the beneficiary inducement prohibitions of the civil monetary penalty statute (CMP) or...more
The Compliance Institute is celebrating 25 years! Join us for the Compliance Institute's 25th anniversary, April 19-22, 2021. This year, HCCA is excited to celebrate over two decades of compliance excellence with our...more
What does Medicare cover? What are the costs of Medicare? What happens if you forget to enroll for Medicare? Medicare is the federal health insurance program for people in the United States who are over the age of 65 or...more
Across the country, hospitals and healthcare providers are facing an unprecedented surge of patients with COVID-19 symptoms while continuing to care for patients with other medical conditions. Responding adequately to the...more
On March 13, 2020, the Centers for Medicare and Medicaid Services (CMS) issued blanket waivers of certain requirements following the President’s National Emergency Declaration. Current waivers are briefly summarized below. ...more
The Centers for Medicare and Medicaid Services (CMS) announced in a March 4, 2020 letter to State Survey Agency Directors that CMS is suspending non-emergency inspections in order to allow inspectors to focus on the most...more
The Centers for Medicare and Medicaid Services (CMS) announced in two letters to State Survey Agencies dated March 4, 2020, new guidance for infection control and prevention concerning coronavirus disease 2019 (COVID-19) in...more