On Wednesday, August 22, 2012, the New York State Department of Health (“DOH”) agreed to pay the owners of the Beechwood Nursing Home, located in Rochester, New York, $25 million dollars to settle litigation in which a federal jury had already determined that DOH officials had illegally revoked the operating license of the facility in 1999 in a retaliation against […]
As of January 1, 2012, all healthcare providers were required to transition from version 4010/4010A to version 5010 standards for submitting electronic transactions, and the failure to comply may result in claim denials or a government investigation. CMS has repeatedly postponed enforcement, but it appears the agency will begin to enforce civil monetary penalties against […]
Increasingly, nursing homes seek guidance on the considerations involved in the use of surveillance equipment in their facilities. On May 22, 2012, the New York State Department of Health issued a “Dear Administrator Letter” (DAL) addressing the use and installation of audio and/or video surveillance equipment in nursing homes. The DAL is available here.
President Obama’s recently released deficit reduction plan proposes to cut more than $320 billion dollars in Medicare and Medicaid spending over the next decade. Within the planned cuts are proposals designed to curb $42 billion dollars of Medicare reimbursement to SNFs and other post-acute facilities. According to the President, expenditures for services these facilities provide […]
On September 6, 2011, New York State entered into a settlement with Disability Advocates, Inc. in resolution of the federal lawsuit, Joseph S. et al. v. Hogan, which challenged the placement of mentally ill patients in nursing homes.
As we previously reported here and here, it was just a matter of time before the Center for Medicare & Medicaid Services (CMS) officially withdrew its rule requiring physician signatures on all laboratory requisitions for clinical diagnostic laboratory tests paid under the Clinical Laboratory Fee Schedule (CLFS). Today, CMS formally withdrew this requirement based on […]
On June 20, 2011, the New York State Senate passed S.5259A (Hannon), a companion bill to A.7343A (Gottfried), which had previously passed the Assembly on June 17, 2011. These bills amend the Family Health Care Decisions Act (FHCDA) to authorize surrogate decision-making regarding hospice care, regardless of whether the patient is in a hospital or nursing […]
Medicaid law forbids nursing facilities from requiring “any gift, money, donation, or other consideration” as a precondition of admission to that facility. See 42 U.S.C. § 1396r(c)(5)(A)(iii); 42 C.F.R. § 483.12(d)(3). On May 10, 2011, the United States District Court for the Western District of Arkansas ruled that an arbitration agreement as a precondition of […]
On March 18, 2011, the Centers for Medicare and Medicaid Services (“CMS”) issued new federal regulations implementing Section 6111 of the Patient Protection and Affordable Care Act and changing the way the federal government imposes and collects civil money penalties (“CMPs”) when nursing homes do not meet Medicare and Medicaid participation requirements. The Final Rule […]