Articles and Blogs

Hospice

Sequestration Cuts Impact Nursing Homes and Post-Acute Care Providers

[04/10/13]

Posted on April 10, 2013 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

In a transmittal issued on April 5, 2013, CMS provided guidance on survey activities that will be affected by the sequestration cuts.  The transmittal provides guidance on several areas that will have an immediate and potentially negative effect on nursing homes and post-acute care providers.  These changes will affect the survey process as conducted by the state survey... READ MORE

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MedPAC Releases Report to Congress, Suggests Broad Reforms to Post-Acute Landscape

[03/18/13]

Posted on March 18, 2013 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Medicare Payment Advisory Commission’s (“MedPAC”) March 25th Report to Congress outlines inefficiencies they believe exist in the post-acute world and lead to excessive Medicare payments to providers. MedPAC recommendations include Congress evaluate post-acute provider reimbursement and encourage use of the lowest cost mix of services necessary to achieve the best outcomes. READ MORE

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Sixth Circuit Determines Nursing Facility Must Prove Lack of Negligence with Missing Documents

[01/11/13]

Posted on January 11, 2013 in Health Law News, Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

In a suit brought against an Ohio nursing facility related to improper medication administration, the U.S. Court of Appeals for the Sixth Circuit allowed the use of res ipsa loquitur in finding a facility responsible for lapses in a resident’s medication regime.   READ MORE

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HHS Announces First Settlement of HIPAA Breach Affecting Less Than 500 Individuals

[01/03/13]

Posted on January 3, 2013 in Long-Term Care, Home Health & Hospice

Written by: Kendra Conover

On January 2, 2013, the Department of Health and Human Services (“HHS”) announced that it had reached a settlement with a hospice provider (“Hospice”) arising from potential violations of the Security Rule under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).  HHS learned of the circumstances giving rise to the enforcement action... READ MORE

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CMS Extends “Extraordinary Circumstances” Hospice Exemption

[10/15/12]

Posted on October 15, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

While hospices are required to ensure that substantially all core hospice services, including nursing services, are performed by hospice employees, hospices have been permitted to utilize contracted staff members to supplement hospice employees during periods of peak patient loads or extraordinary circumstances. The Centers for Medicare & Medicaid Services (CMS) agrees the nation-wide shortage of hospice nurses has... READ MORE

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OIG Publishes Findings of Nurse Aide Criminal History Investigation

[10/09/12]

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

Written by: Bufford, David W.

As part of the Patient Protection and Affordable Care Act (PPACA), the Office of the Inspector General (OIG) was mandated to submit a report to Congress evaluating the Nationwide Program for National and State Background Checks on Direct Patient Access Employees of Long Term Care Facilities and Providers (commonly referred to as the “Background... READ MORE

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OIG Publishes 2013 Work Plan

[10/05/12]

Posted on October 5, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Office of the Inspector General (OIG) has published their annual Work Plan for 2013. The Work Plan continues to identify compliance risk areas that subject Medicare and Medicaid providers to audit and enforcement initiatives. The Work Plan specifically targets skilled nursing facilities (SNFs), hospices, and home health agencies (HHAs). For all types of... READ MORE

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Internet-Based PECOS Improvements Increase Access to Information

[08/14/12]

Posted on August 14, 2012 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

The Centers for Medicare & Medicaid Services (CMS) implemented changes to Internet-based PECOS to allow providers easier access to information. The following enhancements are now available: READ MORE

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CMS Publishes Provider Compliance Map

[08/02/12]

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

Written by: Bufford, David W.

Need a quick reference to find specific contacts at Medicare organizations that service your state? The Centers for Medicare & Medicaid Services (CMS) recently published an interactive Provider Compliance Group Map. Should you have any questions, please contact: Todd Selby at 317.977.1440 or tselby@hallrender.com; Brian Jent at 317.977.1402 or bjent@hallrender.com; or David Bufford at 502.568.9368 or dbufford@hallrender.com, or your regular... READ MORE

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Inappropriate and Questionable Billing by Medicare Home Health Agencies

[08/02/12]

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

Written by: Selby, Todd J.

Data collected and analyzed by the Office of Inspector General (OIG) since 2010, indicate that home health agencies (HHAs) are predisposed to commit Medicare fraud, waste and abuse. In 2010, Medicare inappropriately paid $5 million for erroneous claims submitted by HHAs. With one in four claims being suspect, the OIG established six (6) criteria... READ MORE

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