NYSDOH Agrees to Pay Beechwood Nursing Home $25 Million in Settlement

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 […]

HIPAA: Conversion to Version 5010

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 […]

DOH Issues Guidance on Use of Surveillance Equipment in Nursing Homes

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’s Deficit Reduction Plan Proposes $42 Billion Cut to SNFs, Post-Acute Care Providers

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 […]

New York State Settles Federal Lawsuit Challenging Placement of Mentally Ill Patients in Nursing Homes

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.

CMS Officially Withdraws Physician Signature Requirement

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 […]

New York Legislature Amends Family Health Care Decisions Act to Include Surrogate Decision-Making about Hospice Care

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 […]

Arkansas Federal Court Determines that Arbitration Agreement Is Not Prohibited “Other Consideration” under Medicaid Regulations

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 […]

CMS Issues Final Rule on Civil Money Penalties for Nursing Homes

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 […]