Changes to federal rules governing mergers and acquisitions could have sweeping effects on hospice and other health care transactions. The Federal Trade Commission (FTC) recently finalized a rule that will implement changes to required pre-merger notification forms. Pursuant to the Hart-Scott-Rodino Act, parties to certain transactions must submit these documents to the FTC and other […]
Private equity firms typically turn around and sell an asset within three to five years post-acquisition. However, some may slow that cycle down in today’s economic environment. The presence of private equity firms in the hospice arena has expanded exponentially during the past several years. But this year, deal volume slowed across the board. While […]
When it comes to hospice M&A, both buyers and sellers must have their eyes out for warning signs that could kill a potential deal. Consolidation remains widespread in the hospice space, though transaction volume has slipped in 2023 compared to prior years. During Q1 of this year, about 14 hospice, home care and home health […]
Hospice program integrity has been in the spotlight for at least the past two years, often with high financial stakes for providers. Unified Program Integrity Contractor (UPIC) and Targeted Probe and Educate (TPE) audits are designed to key regulatory safeguards against bad actors in the hospice industry. Both include oversight measures aimed at ensuring hospice […]
Buyers in a hot hospice M&A market are bringing compliance under a microscope as regulators keep a tight watch. All hospice transactions undergo some type of compliance review. But there’s nothing routine about these reviews in today’s current hospice regulatory environment. Combing through a hospice’s referral streams and financial or claims data can help identify […]
Recently proposed amendments to the False Claims Act (FCA) could spell choppy regulatory waters for the hospice industry. Senators introduced a bill that would, among other provisions, shift the burden of evidence and potentially make it easier for whistleblowers to call out hospices on fraud and harder for providers to defend themselves, according to Bryan […]
A fraud and anti-kickback suit against Georgia-Based Bethany Hospice & Palliative Care LLC may be headed to the U.S. Supreme Court. Attorneys for two former Bethany employees have filed a petition to the nation’s highest court after the Eleventh Circuit of the U.S. Court of Appeals dismissed the case in May due to a lack […]
The U.S. Supreme Court has declined to hear arguments in a False Claims Act (FCA) case involving the hospice provider Care Alternatives. FCA actions pertaining to hospices most commonly focus on questions of a patient’s eligibility for those services. A report from Bass, Barry, and Sims shows that a leading cause of fraud involves hospices […]
Hospice organizations and private equity investors are under increasing legal and regulatory scrutiny related to medical necessity complaints under the False Claims Act. A report from Bass, Barry, and Sims shows that a leading cause of fraud involves hospices billing Medicare for services for which patients were not eligible. This resulted in several multi-million dollar […]
False Claims Act (FCA) cases are a leading legal concern for hospice providers as the industry comes under ever-increasing regulatory scrutiny. Knowledge of the law will be the key for hospices to both prevent and build a defense against these kinds of claims, according to health care attorney Nick Jurkowitz of the Fenton Law Group. […]
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