Articles and Blogs

On November 20, 2024, the Office of Inspector General (“OIG”) for the U.S. Department of Health and Human Services (“HHS”) issued new Industry Segment-Specific Compliance Program Guidance For Nursing Facilities (“Nursing Facility ICPG”) for nursing home members of the health care compliance community. Motivating factors for issuing the Nursing Facility ICPG included long-standing issues such... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) has given surveyors new rules and updates to allow surveyors to assess and cite violations of the regulations on resident discharge and transfer. On November 18, 2024, the Quality, Safety & Oversight Group at CMS issued a memorandum entitled “REVISED: Revised Long-Term Care (LTC) Surveyor Guidance: Significant... READ MORE

According to a statement released on the Center for Medicare and Medicaid Services (“CMS”) website, effective February 14, 2025, implementation of the Hospice Special Focus Program for calendar year 2025 has ceased so that CMS may further evaluate the program. Hospice Special Focus Facility Program (“SFP”) The Consolidated Appropriations Act of 2021 called for... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) recently finalized a rule (“Final Rule”) that expands its ability to impose a Provisional Period of Enhanced Oversight (“PPEO”) on providers, including post-acute providers, reactivating their Medicare enrollment. This regulation, authorized under Section 1866(j)(3)(A) of the Social Security Act (“Act”), is designed to strengthen Medicare program... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) has given surveyors new rules and updates to allow surveyors to add extra attention and increase oversight in nursing homes regarding the role of the medical director and how mental disorders are diagnosed. On November 18, 2024, the Quality, Safety & Oversight Group at CMS issued... READ MORE

NATIONAL 5 key health topics to watch at RFK Jr.’s Senate confirmation hearings 6 more states sharpening PE regulation Change breach hit more than half of Americans, UnitedHealth says Epic hits back at Particle Health counterargument as it pushes to get antitrust case dismissed Health systems embark on culture makeovers Healthcare finance trends for... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) is reinforcing its emphasis on hospice quality of care and identifying fraud. On November 13, 2024, CMS issued a QSO Memo, “Ensuring Consistency in the Hospice Survey Process to Identify Quality of Care Concerns and Potential Fraud Referrals” (the “CMS Memo”), addressing the importance of consistency in... READ MORE

On January 10, 2025, Secretary Becerra of the U.S. Department of Health and Human Services (“HHS”) issued a determination titled “Determination That A Public Health Emergency Exists” (the “California PHE Determination”), that decided a public health emergency exists and has existed since January 7, 2025, in the State of California (“California Public Health Emergency”). Blanket Waivers... READ MORE

Effective January 1, 2025, Illinois enacted a law that contains several updates to Illinois’s change of ownership (“CHOW”) laws for nursing homes. Changes to Illinois’ CHOW Laws Illinois Public Act 103-0776 (“CHOW Law”) replaces Sections 3-112,  3-113 and 3-114 of the Illinois Nursing Home Care Act (the “Act”). The CHOW Law provides that nursing... READ MORE

On December 31, 2024, the Centers for Medicare & Medicaid Services (“CMS”) released a memo titled “Long-Term Care (LTC) Facility Acute Respiratory Illness Reporting Requirements” (“Memo”) to state survey agency directors providing survey guidance related to requirements for long-term care reporting through the National Healthcare Safety Network (“NHSN”) as COVID-19 data reporting requirements ended... READ MORE