Host Jonathan Porter welcomes Bryan Nowicki, leader of Husch Blackwell’s hospice practice group and host of the Hospice Insights podcast, to discuss the recent wave of hospice fraud enforcement. With hospice fraud dominating headlines in recent months, Bryan shares insights on how massive fraud schemes are impacting the industry and why legitimate providers face collateral damage.
Host Jonathan Porter welcomes Bryan Nowicki, leader of Husch Blackwell’s hospice practice group and host of the Hospice Insights podcast, to discuss the recent wave of hospice fraud enforcement. With hospice fraud dominating headlines in recent months, Bryan shares insights on how massive fraud schemes are impacting the industry and why legitimate providers face collateral damage.
We begin with the fundamentals, examining why hospice has become such a target for fraudsters. Bryan explains what makes the Medicare hospice benefit particularly vulnerable to exploitation and how the structure of hospice care creates opportunities for bad actors.
Next, we discuss shocking examples from recent California investigations, including 15 hospices incorporated on the same day at the same address. Bryan explains how Medicare’s enrollment processes allow this to happen and why a 97% live discharge rate—reported at one hospice under investigation—is a massive red flag for fraud. We also discuss identity theft schemes, where fraudsters allegedly used stolen data from breaches to enroll patients who were never sick and had no knowledge of their enrollment.
We then pivot to the types of False Claims Act theories DOJ typically pursues against legitimate hospice providers—long length of stay, eligibility determinations that don’t meet LCD requirements, and medically unnecessary crisis care or general inpatient care. Bryan clarifies how these investigations differ dramatically from the egregious fraud schemes making headlines.
Bryan discusses the collateral damage these massive fraud schemes inflict on legitimate hospice providers: increased regulatory scrutiny, reputational harm to the entire industry, chilling effects on patient enrollment, unfair competition from fraudsters, and claims processing problems when identities are already being billed.
We close with a sobering reality: whistleblowers and their attorneys are more likely to pursue FCA cases against legitimate hospices with assets rather than shell companies that have moved money offshore. Bryan explains how the prevalence of fraud in the news may paradoxically cause FCA enforcement to focus on the wrong targets.
Jonathan Porter | Full Biography
Jonathan focuses on white collar criminal defense, federal investigations brought under the False Claims Act, and litigation against the government and whistleblowers. He draws on his experience as a former federal prosecutor to guide clients in sensitive and enterprise-threatening litigation. At the Department of Justice, Jonathan earned a reputation as a top white-collar prosecutor and trial lawyer and was a key member of multiple international healthcare fraud takedowns and high-profile financial crime prosecution teams. He also teaches white collar crime as an adjunct professor of law at Mercer University School of Law.
Bryan Nowicki | Full Biography
Bryan has more than 20 years of litigation and regulatory experience, assisting clients on a nationwide basis with complex litigation, compliance, and business matters with a particular focus on hospice, home health agencies, palliative care organizations, hospitals, and skilled nursing homes. Working closely with clients, he develops practical strategies and remediation when they face issues including state and federal investigations, whistleblower complaints, audits, and federal fraud and abuse claims, among other areas.