Hospice Insights: The Law and Beyond

After ALJ: Options and Opportunities in the Face of an Unfavorable ALJ Decision

Episode Summary

In the five-step audit appeals process, hospices often stop their appeal efforts after finding success at the third step, a hearing before an administrative law judge (ALJ). However, if an ALJ issues an unfavorable decision, the hospice still has recourse. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki talk about dealing with an unfavorable ALJ decision, including how to evaluate the strengths, weaknesses, costs, and benefits of pursuing the remaining steps of the appeal process.

Episode Notes

In the five-step audit appeals process, hospices often stop their appeal efforts after finding success at the third step, a hearing before an administrative law judge (ALJ). However, if an ALJ issues an unfavorable decision, the hospice still has recourse. In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki talk about dealing with an unfavorable ALJ decision, including how to evaluate the strengths, weaknesses, costs, and benefits of pursuing the remaining steps of the appeal process.