Hospice Audits and Investigations: Current Landscape, Preparedness, and Defense

  • Room: 275
  • Session Number: 109
Sunday, October 23, 2022: 2:50 PM - 3:50 PM


Jason Bring JD
Healthcare Attorney
Arnall Golden Gregory, LLP


In this session, we will begin with an overview of the various types of audits and initiatives targeting hospices, following the progression from least intensive (e.g., ADRs) to most intense (False Claims Act). We will cover current types of audit denials, leading to a discussion of how to reduce your organization's risks during an audit. Specifically, this will include how to elevate internal audit and reimbursement to the forefront of compliance. We will finish with an overview of what a government investigation entails, including tips for reducing your company's expense and exposure in advance.



Course Level: Intermediate; 1.2 Accounting CPEs (NASBA/RE) 1 Nursing CNEs contact hours

Learning Outcomes

1. Identify the need to elevate reimbursement risk within your organization and improve internal audits and documentation to reduce denial exposure.
2. Describe the various types of hospice audits, following the intensity progression from ADRs, to SMRCS, UPICs, OIG, and culminating in FCA
3. Discuss what to expect in a government investigation and how to take measures now to reduce your organization's expense and exposure when (not if) you are targeted.