Capabilities / Hospice & Palliative Care

Hospice & Palliative Care

Delivering 360-degree guidance for those supplying hospice & palliative care.

For nearly 20 years, our coast-to-coast legal team has monitored continually shifting hospice & palliative care laws. Our hospice law and palliative care attorneys are nationally recognized thought leaders who anticipate industry issues in order to clear pathways for nonprofit and for-profit clients large and small. Our hospice attorneys implement optimal client positioning on proactive compliance, audits and investigations, licensing, corporate transactions, litigation and growth. Familiar with the legal, clinical and operational demands facing hospice & palliative care organizations, our legal teams efficiently address brief questions by phone as well as providing experienced negotiation during complex multimillion-dollar government audits.

Our hospice & palliative care tools and services include:

Hospice Podcasts

To view other COVID-19 Resources related to Hospice & Palliative Care, visit our content library.

COVID-19 Tools

April 14, 2020: [Blog] Tools for Your Hospice Toolbox: How to Evaluate, Allocate and Track the Use of CARES Act Relief Payments (An Introduction)
April 9, 2020: Tools for Your Hospice Toolbox- Breakdown of Benefits Available Under FFCRA
April 8, 2020: [Blog] Tools for Your Hospice Tool Box: Telehealth Flowchart for Billable Hospice Physician and Nurse Practitioner Services During the COVID-19 Pandemic
April 3, 2020: [Blog] COVID-19 Hospice How-To Series: Application of the FFCRA “Health Care Provider” Exemption to Hospices
March 27, 2020: [Blog] COVID-19 Hospice How-To Series: Taking Advantage of the Temporary Quality Reporting Data Submission Relief
March 20, 2020: [Blog] Tools for Your Hospice Tool Box: If Nursing Facilities Are Improperly Restricting Access to Hospice Personnel During the COVID-19 Pandemic, We Have a Tool That Can Help

To view other COVID-19 Resources related to Hospice & Palliative Care, visit our content library.

Hospice Medicare & Medicaid Audits

Our Hospice Audit team has led the way in the vigorous defense of hospices in payor audits for over a decade, with consistently successful outcomes. Whether the audit relates to Medicare, Medicaid or Medicare Advantage programs, the Hospice Audit team has the experience and skill to obtain the best result possible. The Hospice Audit team has also developed a number of analytical tools, including charts, guides, tracking spreadsheets and tip-sheets for use by hospice personnel. These tools, together with our attorneys’ unrivaled experience in hospice audit, allows the Hospice Audit team to vigorously represent hospices in an efficient and cost-effective manner.

Affiliations, Joint Ventures and Acquisitions

Our experienced and multidisciplinary hospice legal team collaborates to negotiate, draft and review sophisticated and customized agreements that allow hospice and palliative care providers to conduct day-to-day business, adapt to regulations and grow their organizations. Frequent services our hospice attorneys provide include:

Mergers & acquisitions
Joint ventures
Strategic alliances
Vendor and service agreements
Employee and physician agreements

Licensing & Regulatory

Our attorneys stay current with the shifting regulatory landscape and how hospice organizations can remain licensed, certified, enrolled and in compliance at a local, state and federal level. Our hospice attorneys work to proactively streamline operations:

Corporate governance
Quality Assessment and Performance Improvement (QAPI) programs
Medicare licensure, certification and enrollment
Reimbursements, repayments and disclosures
Risk identification and loss reduction

Litigation & Crisis Management

When unexpected claims destabilize ongoing business, our attorneys serve as fierce advocates and seasoned crisis managers. Our legal team navigates suspended payment, risk and exposure while defending clients before local, state and federal judicial, quasi-judicial, administrative and legislative bodies regarding a wide range of issues including:

Whistleblower complaints
Anti-Kickback Statute (AKS)
Stark Law
False Claims Act (FCA)
Investigations & audits

Client Success

Hospice Provider Prevails in False Claims Act Case

Representative Experience

Represented hospice in appeal of a Medicare audit that resulted in an extrapolated overpayment of more than $12 million. Advocated for the hospice through the appeal process including a hearing before an administrative law judge. The extrapolation was thrown out and the ALJ returned a fully favorable ruling, resulting in a final overpayment amount of $0.00.
Through administrative appeal process, decreased alleged $8.6 million hospice client's overpayment identified during Medicare audit to less than 1 percent: $77,000.
Appealed alleged overpayment finding during Medicare audit that placed nonprofit hospice client on brink of ceasing or selling operations, reducing overpayment by approximately $20 million.
Successfully argued for hospice client that Unified Program Integrity Contractor (UPIC)'s $25 million extrapolated overpayment was invalid. At first level of appeal, hospice was vindicated leaving mere $70,000 in dispute.
Negotiated a $2 million settlement of a $25 million UPIC audit securing the hospice's future and its service to the community.
Through advocacy, secured non-intervention decisions by government prosecutors and subsequent case dismissals in numerous qui-tam whistleblower lawsuits across the country.
Secured elimination of $4.4 million extrapolated overpayment demand by UPIC. At reconsideration level of appeal, successfully argued that statistical extrapolation was fundamentally flawed and Qualified Independent Contractor (QIC) agreed that methodology was invalid.
Secured withdrawal of $15 million extrapolated overpayment demand by UPIC. Prior to filing first-level redetermination appeal, successfully argued that payment demand must be rescinded due to fundamental flaws in statistical extrapolation. Achieving withdrawal at this early stage allowed client to avoid years of costly litigation and, due to appeal backlog, the threat that multimillion recoupment would begin before case was heard by administrative law judge (ALJ).
Secured withdrawal of $12 million extrapolated UPIC audit finding before demand letter was issued. Almost immediately persuaded Medicare Administrative Contractor (MAC) and UPIC that fundamental errors were made in audit documentation review, rendering overpayment determinations and statistical extrapolation inaccurate. The hospice was thus able to avoid costly and time-consuming appeal.
At first level of appeal, successfully overturned 84% of UPIC claim denials and secured removal of extrapolation, reducing $7 million repayment to nearly $96,000.
Secured removal of extrapolation decision for hospice resulting in reduction of overpayment from approximately $6 million to approximately $100,000.
Successfully defended one of the first federal hospice Medicaid Integrity Contractor (MIC) audits by obtaining withdrawal of nearly entire $3 million overpayment. Coordinated with local counsel to challenge State's ability to recoup Medicaid nursing home room and board dollars on basis that Medicare hospice services were alleged to have not been medically necessary.
Received favorable decisions from ALJ on all beneficiary denials appealed in extrapolated sample, reducing overpayment from approximately $4.6 million to just under $40,000.
Successfully defended state Medicaid audit seeking to recover $6+ million in nursing home room and board pass-thru payments. After initial response, recoupment was reduced to ~$82,000.

Podcast | January 05, 2022

Beyond Regulations: Hospice Business Contracts and Contract Disputes

Podcast | December 15, 2021

Hospices and The False Claims Act: Proposed Amendment Would Increase Liability Risk

Podcast | December 01, 2021

Strategic Restructuring for the Future, Think Before You Sign: Five Key Insights for VBID and Managed Care Contracts

Podcast | November 11, 2021

COVID-19 Hospice How-To Series: Federal Vaccine Mandate Rules - Breaking Down What They Mean for Hospices

Podcast | October 20, 2021

Hospice Audit Series: Insights for Winning at Administrative Law Judge (ALJ) Hearings, Part II

Podcast | October 06, 2021

Hospice Audit Series: Insights for Winning at Administrative Law Judge (ALJ) Hearings, Part I

Podcast | September 24, 2021

Drumroll Please: The Latest on HIS Appeals

Podcast | September 22, 2021

Strategic Restructuring for the Future, Putting a Plan Into Action: A Conversation With Gloria Brooks on Building End-of-Life Partnerships

Podcast | September 08, 2021

Hospice Audit Series: A Beginning and an End from CMS - TPE Resumes While QIC Demonstration Ends

Video | September 01, 2021

[Video] An Attorney's Perspective for Hospice Boards: Being Proactive for the Future

Blog | August 31, 2021

Parsing Out Changes in the Election Addendum Made by the Final Hospice Wage Index Rule

Podcast | August 25, 2021

Parsing Out Changes in the Election Addendum Made by the Final Hospice Wage Index Rule

Blog | August 20, 2021

Hospice Governance Academy Spotlight Interview: An Attorney's Perspectives for Hospice Boards

Video | August 18, 2021

[Video] An Attorney's Perspective for Hospice Boards: Ensuring an Effective Compliance Program

Podcast | August 11, 2021

Governance Series: Common Board Challenges and Tips for Dealing with Them

Blog | July 30, 2021

An Unexpected Flurry: HIS Noncompliance Letters Have Many Scratching Their Heads

Podcast | July 29, 2021

An Unexpected Flurry: HIS Noncompliance Letters Have Many Scratching Their Heads

Video | July 28, 2021

[Video] An Attorney's Perspective for Hospice Boards

Podcast | July 14, 2021

Staying Prepared: Hospices and the False Claims Act, Part III - Success in False Claims Act Lawsuits

Blog | July 14, 2021

Staying Prepared: Hospices and the False Claims Act, Part III

Podcast | June 30, 2021

Strategic Restructuring for the Future, Succeeding in Value-Based Care: How Hospices Can Collaborate Through Network Models

Podcast | June 22, 2021

COVID-19 Hospice How-To Series: New Deadlines Announced for Reporting on and Using Your Provider Relief Fund Payments

Podcast | June 16, 2021

Privacy Series: HIPAA Breaches - When It Is, and When It Is Not a Breach

Articles | June 04, 2021

American Health Law Association PG Bulletin: Federal Funding for Mental Health Treatment and the IMD Exclusion: Where Do We Stand? (log-in required)

Podcast | June 02, 2021

Hospice Innovators: A Conversation with Dr. Kathleen Benton, CEO of Hospice Savannah

Podcast | May 19, 2021

Staying Prepared: Hospices and the False Claims Act, Part II - Successful Approaches to Government Investigations

Podcast | May 05, 2021

Hospice Audit Series: How are Hospices Faring at ALJ Hearings?

Podcast | April 21, 2021

Hospice Audit Series: CMS Program Integrity Audits Are Back!

Podcast | April 14, 2021

Hospice Audit Series: The Second Guessing of Billed Hospice Physician Visits

Articles | April 12, 2021

HomeCare: Lessons Learned From a Decade of Defending Hospices

Podcast | March 31, 2021

Hospice Audit Series: Spring Audit Bloom—Medicaid UPICs and MAC ADRs

Podcast | March 17, 2021

Staying Prepared: Hospices and the False Claims Act Part 1 - What Will Hospices Face and What Can They Do About It

Podcast | March 03, 2021

Hospice Audit Series: The Latest Developments and Strategies for Success in the Ever-changing Audit Landscape

Podcast | February 17, 2021

Strategic Restructuring for the Future: The State of the Hospice Market

Podcast | February 03, 2021

COVID-19 Hospice How-To Series: The Latest on Using and Reporting Your Provider Relief Funds

Podcast | January 27, 2021

Hospice Survey Overhaul: An Unwelcome Surprise in COVID Relief Bill

Podcast | January 13, 2021

COVID-19 Hospice How-To Series: The Latest on Testing and Vaccinating Employees

Podcast | January 06, 2021

Hospice Innovators: A Conversation with William Finn of Hospice of the Western Reserve

Podcast | December 16, 2020

Governance Series: A Good Hospice Board in Action - What it Looks Like

Podcast | December 02, 2020

Privacy Series: The New Information Blocking Rule - What It Means For Hospices

Podcast | November 11, 2020

Will the U.S. Supreme Court Weigh in on Hospice Prognostication? Industry Hopes to Preserve AseraCare Court Decision.

Podcast | October 28, 2020

Perspectives on End-of-Life Care: An Exploration of Its Past, Present and Future - A Conversation with Dr. Janet Bull

Podcast | October 14, 2020

Enforcement Relief: What New Regulatory Reforms Could Mean for Hospices

Blog | October 06, 2020

Emergency Order #2 Targets Staffing Demands in Wisconsin Healthcare Facilities

Podcast | September 30, 2020

COVID-19 Hospice How-To Series: The Government Yet Again Updates Rules for FFCRA Paid Leave and Provider Relief Fund Reporting

Podcast | September 16, 2020

Governance Series: Working Together - Tips for Ensuring A Compliant Relationship Between You and Your Hospice Board

Podcast | September 02, 2020

Hospice Labor and Employment Trends: Labor Relations Revisited – The Union At Your Door

Podcast | August 21, 2020

No Delay for Hospices: October 1st Brings New Election and Addendum Requirements

Podcast | August 05, 2020

COVID-19 Hospice How-To Series: Hospice Physicians are Being Tested by COVID-19, and Increased Scrutiny Lies Ahead—What to Expect and What to Do

Podcast | July 22, 2020

COVID-19 Hasn't Interrupted Everything: Certain Hospice Audit Activity Continues Despite Public Health Emergency

Alerts | July 16, 2020

COVID-19: CMS Green Lights Contractors to Restart Hospice Medical Reviews

Podcast | July 08, 2020

Innovators Series: A Conversation with Carla Davis, CEO of Heart of Hospice LLC

Podcast | June 24, 2020

Is the Aseracare precedent in jeopardy? Courts Questioning Clinical Judgment Standards

Alerts | June 23, 2020

COVID-19 Hospice How-To Series: A Pleasant Surprise for Hospices As HHS Lifts Relief Fund July 10th Quarterly Compliance Report Deadline

Podcast | June 10, 2020

Are You Ready for October 1, 2020? Honing in on CMS's Impending Election Statement and Election Statement Addendum Requirements

Alerts | June 09, 2020

CARES Act Provider Relief Fund: Connecting HHS's Dots on Whether Your Tranche #1 Payment Is an Overpayment

Podcast | June 03, 2020

COVID-19 Hospice How-To Series: Legal and Accounting Perspectives on Commonly Asked Provider Relief Fund Questions

Podcast | May 22, 2020

COVID-19 Hospice How-To Series: Keeping Up with HHS's Constantly Evolving Guidance on the Provider Relief Fund

Blog | May 15, 2020

Missouri Encourages COVID-19 Diagnostic Testing but Urges Caution with Serological/Antibody Testing

Podcast | April 24, 2020

Innovators Series: A Conversation with Michael McHale, President and CEO of TRU Community Care

Blog | April 21, 2020

How Nonprofits Can Address Development During the COVID-19 Crisis

Podcast | April 14, 2020

COVID-19 Hospice How-To Series: $30 Billion in Relief Funds Made Available, but Strings are Attached!

Blog | April 14, 2020

Tools for Your Hospice Toolbox: How to Evaluate, Allocate and Track the Use of CARES Act Relief Payments (An Introduction)

Podcast | April 10, 2020

Labor and Employment Trends – COVID-19 Edition: FFCRA Insights for Healthcare Providers

Blog | April 10, 2020

CMS Special Open Door Forum Addresses Pressing Telehealth Questions

Blog | April 08, 2020

Tools for Your Hospice Tool Box: Telehealth Flowchart for Billable Hospice Physician and Nurse Practitioner Services During the COVID-19 Pandemic

Podcast | April 03, 2020

COVID-19 Hospice How-To Series: Recent Developments Regarding Telehealth, Virtual Visits, and Medicare Audits and Appeals

Blog | March 30, 2020

The Small Business CARES Act Guide for Those Who Provide Care (Hint: There Are Good Loan Options)

Podcast | March 27, 2020

COVID-19 Hospice How-To Series: Insights and Strategies for Virtual Visits, Telehealth and Medicare Appeals

Blog | March 27, 2020

COVID-19 Hospice How-To Series: Taking Advantage of the Temporary Quality Reporting Data Submission Relief

Blog | March 20, 2020

Tools for Your Hospice Tool Box: If Nursing Facilities Are Improperly Restricting Access to Hospice Personnel During the COVID-19 Pandemic, We Have a Tool That Can Help

Podcast | March 19, 2020

COVID-19 Hospice How-to Series: Navigating and Troubleshooting Coronavirus Challenges

Blog | March 14, 2020

Guidance for Hospice Providers to Address the Visitors Ban Imposed by Nursing Facilities to Reduce the Spread of COVID-19

Podcast | March 05, 2020

The Next Wave From OIG: Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Audits

Podcast | February 20, 2020

Hospice Labor and Employment Trends: The Old and the New in 2020

Podcast | February 06, 2020

Breaking Down TPEs: Facts and Strategies

Podcast | January 23, 2020

Your Hospice Team Has a New Home

Speaking Engagements | March 30, 2021

Speaker, "The Cures Act Information Blocking Rule 101: Key Takeaways for Hospice Compliance," National Hospice and Palliative Care Organization

Speaking Engagements | March 17, 2021

Speaker, "What's Next? Information Blocking: Compliance and Enforcement," Greater Kansas City Healthcare Association

Speaking Engagements | March 4, 2021

Speaker, "Acquisition of Home Health and Hospice Agencies," American Health Law Association

Speaking Engagements | February 17, 2021

Speaker, "10 Years Defending Hospices in Audits and Investigations, What We Learned and What the Future Holds," Illinois Hospice & Palliative Care Organization webinar

Speaking Engagements | October 1, 2020

Speaker, "Hospice Compliance and Legal Update," Hospice Fundamentals 2020 Fall Workshop

Speaking Engagements | August 26, 2020

Speaker, "What the New Wage Index Rule Means: Takeaways and Tips," Kentucky Association of Hospice & Palliative Care webinar

Speaking Engagements | June 5, 2020

Speaker, "CARES Act Provider Relief Fund: Practical Considerations for Hospices in Using Their Relief Payments," California Hospice Network webinar

Webinar | May 27, 2020

COVID-19 Town Hall for Hospices

Speaking Engagements | May 7, 2020

Co-presenter, "Up to the Minute Information on the CARES Act Provider Relief Fund: What You Need to Know," National Hospice and Palliative Care Organization webinar

News | December 17, 2021

Hospice News: FCA Amendments ‘Cast a Wider Net' on Providers

Media Mentions | December 14, 2021

IB Madison: Professional of the Week | Meg Pekarske

News Releases | September 30, 2021

Husch Blackwell's Hospice Team Secures Elimination of 2% Payment Reduction Penalty

Media Mentions | June 09, 2021

Hospice News: Hospices Extending Community Partnerships Developed During COVID

News Releases | May 06, 2021

Husch Blackwell Defeats FCA Whistleblower Litigation for Hospice

Media Mentions | April 23, 2021

Hospice News: Hospice Providers Seeing an Uptick in Regulatory Audits

Media Mentions | March 26, 2021

Hospice News: Private Equity Investment in Hospice Hits All-Time High, Valuations Rising

Media Mentions | March 04, 2021

Hospice News: Husch Blackwell Secures $44 Million Cut in Hospice Overpayments

Media Mentions | February 23, 2021

HomeCare: Husch Blackwell Secures Hospice Overpayment Reduction

News Releases | February 22, 2021

Husch Blackwell's Hospice Team Opens 2021 with Significant Audit Victory

The victory was the most significant victory to date for the Madison, WI-based team, which arrived at Husch Blackwell in January 2020.

Media Mentions | February 16, 2021

Hospice News: HHS Releases New PRF Funding Requirements, Delays First Reporting Deadline

Media Mentions | January 12, 2021

Hospice News: Hospice of the Western Reserve Boosts COVID Resilience Via JVs, Partnerships

News Releases | November 06, 2020

Husch Blackwell Authors U.S. Supreme Court Amicus Brief in Key FCA Litigation

Media Mentions | October 27, 2020

Law360: Justices Told FCA Circuit Split Poses 'Far-Reaching' Threat

Media Mentions | October 01, 2020

Medscape: Physicians Misjudge a Terminal Patient's Life Span: Is It Fraud? (log-in required)

Media Mentions | September 04, 2020

Hospice News: Hospice Employees May Turn to Unions if Feeling Unheard

Media Mentions | June 09, 2020

Hospice News: Hospices Contend with COVID Relief Funding

Media Mentions | February 20, 2020

Madison Magazine: More Than Exceptional - Highlighting the women who go beyond exceptional

Media Mentions | January 29, 2020

Wisconsin Law Journal: Husch Blackwell expands Madison health care team (log-in required)

Media Mentions | January 27, 2020

Law360: Health Hires: Latham, Husch Blackwell, Verrill Dana

News Releases | January 13, 2020

Husch Blackwell Lands Two Healthcare Groups in Wisconsin

“That two prominent groups of lawyers from two different firms see the same potential and opportunity at Husch Blackwell speaks volumes about our firm’s commitment to Madison and the larger Wisconsin market,” said Paul Eberle, Husch Blackwell’s Chief Executive.

Media Mentions | January 13, 2020

Milwaukee Business Journal: Husch Blackwell adds 12 health care attorneys from competing firms in Madison

Media Mentions | January 13, 2020

Urban Milwaukee: Husch Blackwell Lands Two Healthcare Groups in Wisconsin

Media Mentions | January 13, 2020

Wisconsin Law Journal: Husch Blackwell adds 12 attorneys to Madison practice (log-in required)

Related areas of focus:

Healthcare Healthcare Litigation Healthcare M&A, Joint Ventures and Other Transactions Healthcare Providers Healthcare Real Estate Healthcare Regulatory & Compliance Counseling Hospice Medicare & Medicaid Audits Medicaid Reimbursement Strategies

Key Contacts

Meg S.L. Pekarske

Partner

Bryan K. Nowicki

Partner

View our entire team Download Service

Testimonials David Fielding, President and CEO, Trustbridge

"Our nonprofit mission-driven hospice operates in a very conscientious manner. Our Husch Blackwell hospice partners are attuned to that and often assist us in making affordable decisions that also meet our needs. We are confident in the attorneys who assist us and appreciate the team’s knowledge of our organization and operations. They anticipate our needs and convey strategies in a meaningful way. They are outstandingly knowledgeable!"

Read how invested partnerships make a difference

Testimonials Michael Hunt, Managing Owner, Pacific Coast Hospice

"First off, I want to say thank you to you and your team for producing the hospice law podcast. I still remember the first time I found it on Apple Podcasts and thought, “this is so niche this can’t be real?” Then I binged some episodes and now I’m a fan!"

Read how invested partnerships make a difference

Testimonials Christina Remus, Director of Quality, Hospice Austin

"No one compares to the Husch Blackwell Hospice team. They are an exceptionally knowledgeable team and have been extremely helpful in finding solutions to the challenges we encounter. We appreciate their patience, their responsiveness and their ability to fit us in at a moment’s notice. Their proficiency to plan and keep us on track differentiates them from other firms. They are always on top of issues and are wonderful communicators. We have had some great outcomes - no one else compares!"

Read how invested partnerships make a difference

Testimonials Lavonne Noel, Executive Director, Hospice of Dubuque

"Big thanks to Meg Pekarske and the Husch Blackwell team for their assistance with a recent matter. The team's expertise in, and passion for, hospice matters was evident from the start. They are a great legal team."

Read how invested partnerships make a difference

Testimonials Matthew Sawyer, Attorney at Law, Law Offices of Matthew D. Sawyer, P.L.L.C.

“As an attorney and owner of a small, thriving in-home hospice in Texas, I am a huge fan of Husch Blackwell’s excellent podcast, Hospice Insights: The Law and Beyond. I always keep my eyes peeled for the next episode. Most recently, I used the information in two sessions related to HIS to good advantage. My knowledge has deteriorated over the years, and the presentation on HIPAA brought me up to speed on changes in privacy law. I am a big fan.”

Read how invested partnerships make a difference

Testimonials Barb Hansen, Chief Executive Officer, Oregon Hospice & Palliative Care Association

"Meg Pekarske is “the best and brightest” and I think very highly of Husch Blackwell and her colleagues, too. I always learn a lot from the webinars and podcasts Husch Blackwell provides. It’s a great service to the hospice industry."

Read how invested partnerships make a difference

News Release

Hospice team completes first year at Husch Blackwell with a string of client successes.

Learn more

Related areas of focus:

Hospice & Palliative Care

Delivering 360-degree guidance for those supplying hospice & palliative care.

Representative Experience

Related areas of focus:

Key Contacts

Meg S.L. Pekarske

Bryan K. Nowicki

"First off, I want to say thank you to you and your team for producing the hospice law podcast. I still remember the first time I found it on Apple Podcasts and thought, “this is so niche this can’t be real?” Then I binged some episodes and now I’m a fan!"

"Big thanks to Meg Pekarske and the Husch Blackwell team for their assistance with a recent matter. The team's expertise in, and passion for, hospice matters was evident from the start. They are a great legal team."

"Meg Pekarske is “the best and brightest” and I think very highly of Husch Blackwell and her colleagues, too. I always learn a lot from the webinars and podcasts Husch Blackwell provides. It’s a great service to the hospice industry."

Hospice team completes first year at Husch Blackwell with a string of client successes.

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