California Hospice Lawyers

Fenton Jurkowitz Law Group represents California hospices to respond to their business, regulatory, and strategic challenges, including:

Business Transactions

• Formation of entities and business structure
• Physician and Medical Director contracts
• Purchase and sale agreements
• Negotiation of payor contracts
• Service agreements and vendor contracts
• Employment and independent contractor agreements

Regulatory Defense

• Department of Public Health (“DPH”) licensure investigations and appeals
• Reimbursement audits by private and governmental payors and their contractors
  • CMS
  • Medicare
  • Medi-Cal
  • National Government Services
• Fraud and abuse investigations by government payors and their contractors
  • Safeguard Services
  • Office of Inspector General
  • Federal Bureau of Investigations
  • Department of Justice
  • Department of Health Care Services
  • Bureau of Medi-Cal Fraud and Elder Abuse
• Audit defense
  • Zone Program Integrity Contractor (“ZPIC”)
  • Recovery Audit Contractor (“RAC”)
  • Program Integrity Safeguard (“PSC”)

Compliance

• Licensing, operational, and reimbursement compliance
• Medicare and Medi-Cal enrollment and changes of ownership
• Corrective action plans and other compliance strategies
  • Prepayment review
  • Licensure citations and deficiencies
  • Medicare and Medi-Cal enrollment errors
• Audit risk assessment
  • Medical necessity of hospice claims
  • Length of stays and number of nursing home patients
  • Physician certifications and re-certifications
• Local Coverage Determination compliance and documenting medical necessity
  • Terminal status in routine hospice claims
  • Special physician service claims
  • Inpatient hospice claims
• Compliance with hospice cap
• HIPAA and state patient data privacy and security requirements
• False Claims Act compliance for marketing and business development activities

Litigation

• Licensure defense and appeals
• Medicare and Medi-Cal provider enrollment appeals
• Payor and reimbursement disputes
• Overpayment appeals
• False Claims Act/qui tam whistle-blower litigation defense
• Business and employment litigation
• Medicare and Medi-Cal exclusions and suspensions by government entities
  • CMS
  • Office of the Inspector General
  • California Department of Health Care Services