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"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."

Lavonne Noel, Executive Director, Hospice of Dubuque


Devoted to the needs of hospice clients nationwide, Meg offers counsel and innovative strategy on compliance, audits, litigation and growth.

Having practiced hospice law across the country for more than 20 years, Meg and the Husch Blackwell Hospice & Palliative Care Team know this healthcare space and have evolved with it. Meg anticipates industry trends and efficiently clears pathways for clients large and small, whether in a 15-minute call or negotiating a multimillion-dollar Unified Program Integrity Contractor (UPIC) audit. She enjoys strategizing solutions for clients on hospice legal issues including:

  • Government audits
  • Fraud investigations
  • Compliance
  • Fraud and abuse
  • Litigation
  • Palliative care program development
  • Inpatient unit structures
  • Contracting issues

Meg collaborates with leading groups such as the National Hospice and Palliative Care Organization (NHPCO), fostering education and monitoring developments on behalf of clients. In addition to proactive regulatory work and resolving obstacles, Meg enjoys facilitating client growth and innovative partnership opportunities with health systems and post-acute care providers as well as guiding hospices through mergers and acquisitions. She shares insights on hospice and palliative care, and speaks to industry innovators as host of the podcast “Hospice Insights: The Law and Beyond.” The most rewarding aspect of her practice is knowing that each person she encounters is working toward the same goal: providing compassionate, quality, end-of-life care to patients.

"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."

Lavonne Noel, Executive Director, Hospice of Dubuque




  • The Best Lawyers in America®, Health Care Law, 2010-2024; Madison Health Care Law "Lawyer of the Year," 2022
  • JD Supra Readers' Choice Awards, Top Author, Healthcare, 2021 and 2023
  • Who’s Who in American Law
  • Wisconsin Super Lawyers, Rising Star, Healthcare, 2006-2007, 2011-2015
  • Wisconsin Law Journal, Woman in the Law Award, 2016


  • J.D., University of Wisconsin Law School
    • cum laude
  • B.S., Edgewood College
    • summa cum laude


  • Wisconsin
  • U.S. Supreme Court

Professional Memberships and Certifications

  • National Hospice and Palliative Care Organization (NHPCO), Regulatory Committee
  • National Partnership for Hospice Innovation (NPHI)
  • American Health Law Association (AHLA)
  • State Bar of Wisconsin, Health Care and Elder Law Sections

People sometimes think lawyers need to be a certain way, but everyone here is different.

  • 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.
  • 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.
Podcast | September 24, 2021
Drumroll Please: The Latest on HIS Appeals
Podcast | February 06, 2020
Breaking Down TPEs: Facts and Strategies
Podcast | January 23, 2020
Your Hospice Team Has a New Home
Webinar | November 2020
Health Law & Innovation Virtual Series - Stimulus Relief Funds: Strings Attached

Health Law & Innovation Virtual Series

Webinar | May 27, 2020
COVID-19 Town Hall for Hospices
Media Mentions | February 02, 2023
HomeCare: Hospice Audits Surged in 2022, Firm Says
Media Mentions | December 14, 2021
IB Madison: Professional of the Week | Meg Pekarske
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 | October 2020
Best Lawyers® 2021: The Midwest Issue
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.

Outside the Office

Meg is inspired by art and design.

Meg enjoys the creative pursuits of painting, drawing, interior design and fashion. She also is an avid traveler, reads philosophy, practices yoga and meditation, and bakes.

Community Leadership
  • Edgewood College, Alumni Board, Past President
  • Shake Rag Alley Center for the Arts, Past Board Member
  • Madison Museum of Contemporary Art (MMoCA), Past President of Art Partners