Articles and Blogs

The Department of Health and Human Services Office of Inspector General (“OIG”) recently issued Advisory Opinion 14-01 (“Advisory Opinion”) approving an arrangement between a placement agency and several senior residential communities that allows the senior communities to compensate the placement agency for the referral of new residents to a participating community (the “Proposed Arrangement”).1 The OIG believed…Read More

President Obama introduced his fiscal year (“FY”) 2015 budget yesterday, and there are many proposed cuts to post-acute care providers.  Some of the highlights include a number of bundled payment initiatives, a $100 co-pay for home health patients not discharged from a hospital and re-admission penalties for skilled nursing facilities (“SNFs”) with high hospital re-admissions….Read More

Overview Since the U.S. Department of Health and Human Services (“HHS”) announced on October 30, 2013 that it does not consider Qualified Health Plans (“QHPs”) purchased on a federal or state marketplace established under the Affordable Care Act (“Marketplaces”) to be “Federal health care programs,”1 there has been significant debate in the health care industry…Read More

As the EEOC continues to focus on the use of unpaid leave beyond policy limits as a potential reasonable accommodation and employees continue to request leave extensions, I am frequently asked: “How do I know when enough is enough?”  Unfortunately, the determination of an undue hardship is a factual issue, and the only way to…Read More

CMS Releases DSH Allotments On February 27, CMS posted its fiscal year 2014 preliminary funding allotments to states for Medicaid Disproportionate Share Hospitals (“DSHs”).  DSH funds were slated to be cut this year under the Affordable Act (“ACA”), but the cuts were delayed in December when Congress passed the Bipartisan Budget Act of 2013.

Time to Get Serious The NLRB has scheduled two days for public comment on the proposed “Quickie Election Rule” that we reported in our article “Quickie Election Rule II” – The NLRB Tries Again earlier this month.  The meetings will be held in Washington D. C. on April 10 and 11.  The deadline for written comments on…Read More

With the October 1, 2014 deadline for ICD-10 compliance looming, many providers might have been holding out in hope that the implementation would again be delayed.  However, Marilyn Tavenner, the administrator of CMS, stated today that there will be no further delays for ICD-10 and the system will go live October 1.

Marilyn Tavenner, the administrator of CMS, indicated that providers, payers and claims clearinghouses can look for no relief from the looming October 1 compliance deadline for the nationwide conversion to the ICD-10 family of diagnostic and procedural codes. She made this statement in her February 27, 2014 address to the HIMSS convention in Orlando as…Read More

Earlier this week, McKnight’s reported on a study from the Mount Sinai School of Medicine in New York relating to the length of stay at for-profit versus nonprofit hospice providers.  This study showed that, of the 600 Medicare certified hospices nationwide, for-profit hospices were more likely to have patients with a longer expected stay than nonprofit…Read More

The Office for Civil Rights (“OCR”) published a Spanish version of its model Notice of Privacy Practices (“NPP”) on February 19, 2014.  The English version of the OCR model NPP was published in September 2013 and comes in four formats (layered, booklet, full page and text) and two versions (one for health care providers and one for…Read More