Hospice Insights: The Law and Beyond

AI tools are already showing up in hospice operations whether organizations have formal policies for them or not—and the compliance and liability questions are emerging just as quickly. In the second part of this two-part series, Husch Blackwell’s Bryan Nowicki and Taylor Crossley break down what the legal exposure looks like across clinical documentation, vendor relationships, and billing, and they take hospice leaders through concrete steps for building AI governance to stay ahead of associated risks.

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AI tools are already showing up in hospice operations whether organizations have formal policies for them or not—and the compliance and liability questions are emerging just as quickly. In this two-part series, Husch Blackwell’s Bryan Nowicki and Taylor Crossley break down what the legal exposure looks like across clinical documentation, vendor relationships, and billing, and they take hospice leaders through concrete steps for building AI governance to stay ahead of associated risks.

CMS’s CY 2027 Home Health Proposed Rule tucks a sweeping set of Medicare provider enrollment changes inside what is nominally a routine payment rule, expanding the grounds on which CMS can deny or revoke a provider’s enrollment. In this episode, Husch Blackwell’s Bryan Nowicki and Andrew Brenton unpack several of the rule’s most consequential proposals, including new denial and revocation grounds and retroactive revocation effective dates. They also discuss why home health agencies and hospices should be paying close attention as the rule moves toward finalization.

CMS’s efforts to crush fraud in the hospice space have commanded the headlines and the attention of many. Less publicized efforts on behalf of hospices in the federal courts, however, have resulted in several rulings favoring hospices. In particular, the federal courts are starting to recognize that hospices deserve the benefit of the doubt when it comes to prognosticating a six-month life expectancy. In this episode, Bryan Nowicki talks with Joe Diedrich and Zaina Niles about those court cases and what they mean for the hospice community.

Hospice providers are no strangers to sensitive patient situations, but a subpoena or other third-party request for patient records can quickly raise complex legal and compliance challenges. In this episode, Husch Blackwell’s Bryan Nowicki and Taylor Crossley provide a practical roadmap for navigating those requests. They discuss the HIPAA framework governing legal process disclosures, the types of demands hospice providers often encounter, and how state privacy laws can affect the analysis—and offer guidance for avoiding common compliance pitfalls when responding to requests for patient information.

CMS revised the Medicare 60-Day Repayment Rule, changing how overpayments are identified. In this episode, Husch Blackwell’s Bryan Nowicki and Andrew Brenton analyze this change and how it affects the time frames applicable to internal investigations and repayment obligations. They also introduce a handy one-page summary of key deadlines.

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60-Day Repayment Rule

In hospice and home health, certain compliance problems can have a big impact on the organization’s bottom line—and ability to keep operating. Even seemingly minor issues can affect whether the organization will be fully paid for services it provided, subject to financial penalties, or even barred from participating in a payment program. To help home health agencies and hospices spot and prevent these problems, Husch Blackwell has created checklists of top compliance issues for hospice and home health, plus template spreadsheets for prioritizing and addressing each. In this episode, Husch Blackwell’s Bryan Nowicki, Andrew Brenton, and Josi Wergin discuss these tools and how you can use them.

Get the Hospice and Home Health Compliance Checklists

Hospice providers remain under heavy scrutiny, with prepayment audit and other audit activity on the rise. Unified Program Integrity Contractors (UPICs) historically conducted post-payment reviews. However, over the last six months, they have joined Medicare Administrative Contractors in reviewing claims on a prepayment basis. In this episode, Husch Blackwell’s Bryan Nowicki and Zaina Niles discuss this new type of UPIC audit and what your hospice can expect if a UPIC picks you.

Since September 2024, CMS’s Medicare Administrative Contractors have been conducting expanded prepayment reviews (also known as “EPRs” or targeted high-risk reviews) of existing hospice providers in Arizona, California, Nevada, and Texas. As of December 2025, hospices in Georgia and Ohio are also under the microscope. In this episode, Husch Blackwell attorneys Bryan Nowicki and Zaina Niles discuss how hospices can differentiate between EPRs and other audit types. You’ll also learn what to expect throughout the EPR process and strategies to overcome claim denials and other possible EPR consequences.

Since July 13, 2023, CMS has applied a Provisional Period of Enhanced Oversight (PPEO) to “new” hospice providers in Arizona, California, Nevada, and Texas. On December 30, 2025, CMS announced it was expanding PPEO to Georgia and Ohio. In this episode, Husch Blackwell attorneys Bryan Nowicki and Adam Royal discuss how these changes impact new (and not-so-new) hospice providers.