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ACA

King v. Burwell – ACA Death Spiral Averted

[06/26/15]

Posted on June 26, 2015 in Health Law News

Published by: Hall Render

In an eagerly awaited, mightily impactful health care decision, King v. Burwell (U.S. No. 14-114 June 25, 2015), the Supreme Court of the United States (the “Supreme Court”) held that individuals eligible for tax credits to subsidize their purchase of health insurance in health care marketplaces created by the Affordable Care Act (“ACA”) may... READ MORE

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DOJ Intervenes in Retained Overpayment Suit

[06/30/14]

Posted on June 30, 2014 in False Claims Act Defense

Written by: Drew B. Howk

With the passing of the Affordable Care Act (“ACA”), False Claims Act (“FCA”) observers noted the imminent filing of cases alleging violations of the ACA’s amendments to the FCA or “reverse” false claims. Such claims are per se false claims under the FCA and arise when a government contractor or health care provider becomes aware... READ MORE

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This Week in Washington – November 8, 2013

[11/08/13]

Posted on November 8, 2013 in Federal Advocacy

Written by: John Williams

OMB Reviewing Final Rules on Anti-Kickback Statute, Stark Law Protections for EHR Deals Earlier this week, CMS and HHS sent two final rules to the White House Office of Management and Budget (“OMB”) that would extend safe harbor protections for arrangements that provide electronic health record (“EHR”) products to physicians until the end of... READ MORE

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Rebasing Has Arrived – CMS Publishes Home Health PPS 2014 Proposed Rule

[07/02/13]

Posted on July 2, 2013 in Long-Term Care, Home Health & Hospice

Written by: Robert W. Markette

On June 27, 2013, CMS released the proposed home health prospective payment rule (the “PPS Rule”) for calendar year 2014.  While refinements to the ICD-9-CM and discussions of ICD-10-CM implementation are of interest, the most notable change to the PPS Rule for 2014 is CMS’s long-awaited proposal for rebasing home health payments.  Once it... 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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Final Rule Published Regarding Nursing Facility Closure Requirements

[03/20/13]

Posted on March 20, 2013 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

On March 19, 2013, the Centers for Medicare & Medicaid Services’ (“CMS”) Final Rule regarding notification and relocation requirements for closing a long-term care (“LTC”) facility was published in the Federal Register. Under the new requirements, 60 days prior to the closure of an LTC facility, the administrator must provide written notice to the... READ MORE

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CMS Expected to Postpone Compliance Program Enforcement

[03/01/13]

Posted on March 1, 2013 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Centers for Medicare & Medicaid Services (CMS) has unofficially announced it will not be enforcing the upcoming March 23rd compliance program requirements until final regulations are published.  As required under the Affordable Care Act, nursing facilities are required to have a compliance program in place by March 23, 2013.  Despite ambiguity in the actual statute,... READ MORE

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Hand in Hand Training for Nurse Aides

[09/21/12]

Posted on September 21, 2012 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

On September 14, 2012, CMS published a Survey and Certification letter addressing “Hand in Hand: A Training Series for Nursing Homes.” This training is in response to Section 6121 of the Affordable Care Act, which requires that CMS ensure that nurse aides receive regular training on caring for residents with dementia and prevention of... READ MORE

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Study Reports SNF Providers Face Grim Reimbursement Future

[08/02/12]

Posted on August 2, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Alliance for Quality Nursing Home Care (AQNHC) released the results of a study conducted concerning the future of skilled nursing facility (SNF) reimbursement.  While SNF providers have recently seen their reimbursement rates improve, the study report projects SNF providers are facing $65 billion in reimbursement cuts over the next ten years. The reimbursement... READ MORE

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