Articles and Blogs

ACO Final Regulations Are Here!

[10/20/11]

Posted on October 20, 2011 in Health Law News

Published by: Hall Render

This installment of Hall Render’s Health Law Broadcast series on health care reform is designed to provide you with the insight, analysis and practical suggestions with respect to the various reform initiatives that will affect your organization.  The very much anticipated final regulations for the new Shared Savings Program under Section 3022 of the Affordable Care…Read More

Medicare Reforms Will Reduce Regulatory Burdens for Hospitals and Health Care Providers and Increase Revenue

[10/19/11]

Posted on October 19, 2011 in Long-Term Care, Home Health & Hospice

Written by: Brian D. Jent

On October 18, 2011, the Centers for Medicare & Medicaid Services (CMS) initiated two sets of regulatory reforms and finalized a third that are designed to improve transparency and allow providers to operate with increased efficiency. One set proposes updates to Medicare Conditions of Participation (CoPs) for hospitals and critical access hospitals (CAHs) and the…Read More

CLASS Act Halted by Obama Administration

[10/14/11]

Posted on October 14, 2011 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

Just weeks after ongoing development of the CLASS Act stalled, Secretary Sebelius announced today the implementation of the CLASS Act has been completely halted.  Reflecting concerns over the sustainability of the program and the potential for the development of a new entitlement program, the Department of Health and Human Services determined the financing plans related to the Act were…Read More

Hospice Owner Indicted for $14.3 Million in False Claims

[10/14/11]

Posted on October 14, 2011 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

On October 12, 2011, the U.S. Department of Justice unsealed an indictment charging Matthew Kolodesh a/k/a Matvei Kolodech, with conspiracy to defraud Medicare of more than $14 million.  According to the indictment, Kolodesh’s business, Home Care Hospice, Inc. (HCH), located in Philadelphia, PA, submitted Medicare claims for approximately $14.3 million dollars for patients who were…Read More

PRRB Rules in Favor of Hospitals on Two Wage Index Issues

[10/13/11]

Posted on October 13, 2011 in Health Law News

Published by: Hall Render

On October 6, 2011, the Provider Reimbursement Review Board released Decision No. 2012-D1 ruling on two issues related to proper calculation of “total paid hours” when calculating the wage index for hospitals in Cincinnati and rural Iowa.  Both issues related to hour recorded as paid by the hospitals but not actually worked by employees.  In…Read More

Legislation Introduced to Dismantle “Specialty Healthcare” NLRB Decision, Further Limit NLRB Actions

[10/13/11]

Posted on October 13, 2011 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

Representative John Kline of Minnesota introduced the Workforce Democracy and Fairness Act last week in response to recent NLRB actions affecting employers.  One aspect of this Bill is the reversal of the NLRB’s Specialty Healthcare decision which altered the established standard for determining collective bargaining units in non-acute care health facilities.   

CMS Updates Claims Processing Manual to Reflect Failure of Timely Hospice Face-to-Face

[10/11/11]

Posted on October 11, 2011 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

As previously discussed, hospice providers are required to have a hospice physician or nurse practitioner perform a face-to-face encounter with each hospice patient whose total length of stay is anticipated to reach the third benefit period.  This encounter must be performed no more than thirty days prior to the third benefit period recertification, and no…Read More

OIG Publishes 2012 Work Plan

[10/11/11]

Posted on October 11, 2011 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

On October 5, 2011, the Office of Inspector General (OIG) published its proposed Work Plan for Fiscal Year 2012. As in the past, the Work Plan continues to identify compliance risk areas that subject Medicare and Medicaid providers to audit and enforcement initiatives. The 2012 Work Plan contains several new areas of focus by the…Read More

Revised 855S Enrollment Application

[10/11/11]

Posted on October 11, 2011 in Long-Term Care, Home Health & Hospice

Written by: Kendra Conover

After October 31, 2011, DMEPOS suppliers will no longer be permitted to use the 07/09 version of the CMS-855S application and will be required to utilize the updated 07/11 version. The 07/11 version is available and may be used for submissions now. The newest version of the application has been updated to capture additional information…Read More