Articles and Blogs

regulation

OIG Final Rule Significantly Expands Exclusion Authority

[01/19/17]

Posted on January 19, 2017 in Health Law News

Published by: Hall Render

On January 12, 2017, the Department of Health and Human Services Office of Inspector General (“OIG”) published the “Health Care Programs: Fraud and Abuse; Revisions to the Office of Inspector General’s Exclusion Authorities” Final Rule (“Final Rule”) revising and expanding its authority to exclude individuals and entities from participation in federal health care programs.... READ MORE

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Massive Spike in FCA Penalties

[05/04/16]

Posted on May 4, 2016 in False Claims Act Defense

Written by: David B. Honig

In November 2015, the Bipartisan Budget Act of 2015 went into effect. One aspect of that act was the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015. The new law required that the Program Fraud Civil Remedies Act and the False Claims Act (“FCA”) penalties be “corrected” to adjust for inflation since their... READ MORE

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Up the Creek Without a Regulation

[02/16/15]

Posted on February 16, 2015 in False Claims Act Defense

Written by: David B. Honig

by David B. Honig and Brian C. Betner CMS Announces Further Delay of Repayment Rule To be published in the February 17, 2015 Federal Register, CMS has extended its deadline for finalizing the Affordable Care Act’s (“ACA”) 60-day payback rule. This is the rule that requires a Medicare or Medicaid provider to return an identified overpayment within... READ MORE

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Extension of Due Date for Nursing Home Automatic Sprinkler Installation

[05/22/14]

Posted on May 22, 2014 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

On May 16, 2014, CMS issued a Survey and Certification Transmittal (“Transmittal”) to the state survey agency directors providing infomation on how Medicare and Medicaid certifed long-term care facilities may obtain an extension of time for the installation of automatic sprinkler sytems.  The Transmittal sets forth the procedures on how a nursing home may seek an... READ MORE

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CMS Comments on Compliance, QAPI Regulations

[03/22/13]

Posted on March 22, 2013 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

During yesterday’s Open Door Forum, Jeanette Kranacs, the Director of the Division of Institutional Post-Acute Care for the Centers for Medicare and Medicaid Services (“CMS”) commented that CMS will not be issuing instructions to surveyors on evaluating compliance and ethics programs until the regulations have been promulgated.  CMS was required to have final regulations and various tools in place as of... READ MORE

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CMS Proposes Extension on Automatic Sprinkler Requirements

[02/07/13]

Posted on February 7, 2013 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

In 2003, two fires in long-term care facilities resulted in 31 resident deaths. As a result of these two events, CMS analyzed the fire safety precautions in place in these facilities and determined that resident safety could be greatly improved by requiring that all long-term care facilities have automatic sprinkling systems installed throughout the... READ MORE

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Deadline Looming for Nursing Facility Compliance Program Requirement

[02/06/13]

Posted on February 6, 2013 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Patient Protection and Affordable Care Act (PPACA) requires all skilled nursing facilities (SNFs) and nursing facilities (NFs) to have an effective compliance and ethics program in place by March 23, 2013.  Unfortunately, the Centers for Medicare & Medicaid Services (CMS) has failed to publish final regulations covering these programs, as required under PPACA, by... READ MORE

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OIG Report Finds Extensive Misuse of Antipsychotics in Nursing Facilities

[07/09/12]

Posted on July 9, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Office of Inspector General (OIG) released a report this morning detailing issues found in the use of antipsychotics in nursing facilities.  Utilizing a sample of records from January through June of 2007, the OIG found over 99% of records reviewed failed to meet one or more Federal requirements.  

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CMS Releases 2012 Nursing Home Action Plan

[07/06/12]

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

Written by: Bufford, David W.

The Centers for Medicare & Medicaid Services (CMS) just released the 2012 Nursing Home Action Plan; a guide for CMS’ efforts to continue to improve nursing home safety and quality.  The plan features 5 actionable strategies, including: enhance consumer engagement; strengthen survey processes, standards, and enforcement; promote quality improvement; create strategic approaches through partnerships; and... READ MORE

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Another Antipsychotic Measure Fails to Pass

[07/06/12]

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

Written by: Bufford, David W.

In an on-going push to regulate the use of antipsychotic medications in nursing facilities, another piece of legislation has failed to pass Congress.  The Senate did not pass a proposed regulation that would have standardized protocols for obtaining informed consent before administering antipsychotics for off-label use.  

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