Absher v. Momence: A Mixed Decision—Limiting and Expanding the False Claims Act

In the ever-expanding area of the federal False Claims Act, the recent decision by the 7th Circuit in Absher v. Momence Meadows Nursing Center Inc., limited pursuing a False Claims Act violation under the worthless services theory but potentially expanded what administrative reports do not trigger the public disclosure bar of the False Claims Act. […]

Selected Bills before New York State Senate Health Committee for the 2013 Session

A few bills of note for health care providers in New York were introduced in the New York State Senate with the opening of the 2013 legislative session.  Each of these bills was formally introduced on January 9 and referred to the Senate Health Committee. An act allowing patients to see their laboratory results upon […]

Eco-Friendly Cleaning Supplies in Nursing Homes and Adult Homes on Senate Agenda

The New York State Senate Health Committee will consider a bill that may ultimately require nursing homes, adult homes, senior centers, and other residential health care facilities to use environmentally-sensitive cleaning and maintenance products.  Senator Diaz will introduce the bill on January 9. The bill, S.866-2013, would require the Commissioner of Health to create “guidelines […]

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 […]

Gov. Cuomo Announces Agreement on Justice Center Legislation to Protect People with Special Needs and Disabilities

Today, Governor Andrew M. Cuomo, Senate Majority Leader Dean Skelos, and Assembly Speaker Sheldon Silver announced an agreement on legislation that will establish a new Justice Center for the Protection of People with Special Needs, which will change how the state protects New Yorkers in state-operated, certified, or licensed facilities and programs. As we previously […]

NY State Seeks Medicaid Waiver to Redesign Health Care System

Governor Andrew Cuomo announced on Tuesday, June 5, that New York State will seek to spend $10 billion in Medicaid savings to redesign the state’s health care system. The state must ask the Federal Department of Health and Human Services (“HHS”) for a waiver that would allow the state to use up to $10 billion […]

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.

Supreme Court Upholds Applicability of Federal Arbitration Act to Predispute Nursing Home Arbitration Agreements

The use of arbitration clauses in nursing home admission agreements is a growing trend.  In some states, however, there is bias against the enforcement of such clauses, particularly those adopted prior to the occurrence of the events that give rise to the dispute.  Some state courts have gone so far as to hold that predispute […]

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 […]