Articles and Blogs

CMS Postpones Two Anti-Fraud Initiatives

[02/06/12]

Posted on February 6, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Centers for Medicare & Medicaid Services (CMS) has pushed back the start of two anti-fraud programs to June due to provider concerns.  Two pilot programs, one that would require prior authorization for scooters and power wheelchairs and one allowing recovery audit contractors (RAC) to review claims prior to payment, were initially slated to begin January 1, 2012.  

Congressional Budget Office Estimates Federal Health Care Program Spending to Double over Next 10 Years

[02/03/12]

Posted on February 3, 2012 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 Congressional Budget Office (“CBO”) recently released a report detailing the nation’s budget and economic outlook for the next…Read More

Two Bills Under Discussion in Kentucky to Affect Litigation Actions

[02/02/12]

Posted on February 2, 2012 in Litigation Analysis

Published by: Hall Render

Two bills in Kentucky are currently under discussion that will, if enacted, impact litigation of contracts with arbitration clauses and cases involving malpractice of long-term care providers.  These bills significantly alter the current process for such actions. One bill, introduced as House Bill (HB) 88, changes the established treatment of arbitration clauses in contracts.  Currently…Read More

Right to Work Becomes Law in Indiana

[02/01/12]

Posted on February 1, 2012 in Health Law News

Written by: Stephen W. Lyman

February 1, 2012 Right to Work Becomes Law in Indiana On February 1, 2012, Indiana became the 23rd state to enact “Right to Work” with Governor Mitch Daniels’ signature on House Bill 1001 after it passed the Senate by a vote of 28 to 22. This Right to Work law has been a long time…Read More

Health Care Real Estate Outlook Remains Strong

[02/01/12]

Posted on February 1, 2012 in Health Law News

Written by: Dick, Andrew A.

During the 4th quarter of 2011, Grubb & Ellis (G&E) released their investor outlook for health care properties. The report states that demand is strong and that health care properties will continue to be a reliable investment over the next decade. G&E points to a number of factors to justify its outlook. The driving force…Read More

Do Men Have a More Difficult Time Finding LTC?

[02/01/12]

Posted on February 1, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The New York Times (NYT) had an interesting article in their The New Old Age segment that described the issues men have in finding appropriate long-term care facilities.  The article highlighted an intuitive, yet often overlooked issue concerning the number of rooms a facility has versus the number of beds.  Many facilities have two beds…Read More

CMS Updates MSN for Hospice Services

[01/31/12]

Posted on January 31, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Centers for Medicare & Medicaid Services (CMS) has responded to criticism detailing how Medicare contractors present hospice service charges in the Medicare Summary Notice (MSN) to beneficiaries.  In recent years, CMS has added new reporting requirements for visit data on hospice claims.  This resulted in an expansion of the information of the claim record to better understand the…Read More

Antitrust Implications for ACOs: FTC/DOJ Determine ACOs are Consistent with Indicia of Clinical Integration – Is This a Fundamental Shift in Antitrust Policy?

[01/31/12]

Posted on January 31, 2012 in Health Law News

Published by: Hall Render

With the advent of the Patient Protection and Affordable Care Act (“ACA”), we are entering a new era of clinical integration and coordinated care.  The government is interested in actively facilitating better care for patients, better health for populations and lower health care costs.  To achieve this three part objective, CMS is championing the Medicare…Read More

Hart-Scott-Rodino Premerger Notification Filing Thresholds Increase for 2012

[01/30/12]

Posted on January 30, 2012 in Health Law News

Published by: Hall Render

Background The Hart-Scott-Rodino Antitrust Improvements Act of 1976, as amended (“HSR Act”), requires all persons contemplating certain mergers or acquisitions that meet or exceed the jurisdictional thresholds (shown below) to file notification with the Federal Trade Commission and Department of Justice Antitrust Division and to wait a period of time before consummating the transaction. Each…Read More

CMS Seeks Savings Through Changes in Medicaid Drug Payments

[01/30/12]

Posted on January 30, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule that enacts a provision of the Patient Protection and Affordable Care Act (PPACA) that seeks to make Medicaid reimbursement for medications more transparent and more closely aligned with what pharmacies pay for the drugs.  In a press release, CMS states the rule…Read More