Articles and Blogs

On June 29, 2012, The Joint Commission (“TJC”) released proposed requirements for the certification (“Certification Requirements”) of Primary Care Medical Homes, also known as Patient Centered Medical Homes (“PCMH”).  Although the certification will not be available until early 2013, TJC is seeking comments on the Certification Requirements until August 10, 2012.

Need a quick reference to find specific contacts at Medicare organizations that service your state? The Centers for Medicare & Medicaid Services (CMS) recently published an interactive Provider Compliance Group Map. Should you have any questions, please contact: Todd Selby at 317.977.1440 or tselby@hallrender.com; Brian Jent at 317.977.1402 or bjent@hallrender.com; or David Bufford at 502.568.9368 or dbufford@hallrender.com, or your regular Hall…Read More

Data collected and analyzed by the Office of Inspector General (OIG) since 2010, indicate that home health agencies (HHAs) are predisposed to commit Medicare fraud, waste and abuse. In 2010, Medicare inappropriately paid $5 million for erroneous claims submitted by HHAs. With one in four claims being suspect, the OIG established six (6) criteria that…Read More

The Alliance for Quality Nursing Home Care (AQNHC) released the results of a study conducted concerning the future of skilled nursing facility (SNF) reimbursement.  While SNF providers have recently seen their reimbursement rates improve, the study report projects SNF providers are facing $65 billion in reimbursement cuts over the next ten years. The reimbursement cuts,…Read More

On August 1, 2012, the Centers for Medicare and Medicaid Services (“CMS”) published a display copy of the Final Rule for the FFY 2013 Inpatient Prospective Payment System (“PPS”).  Hospitals will see an approximately 2.3% net increase in payments in FFY 2013. Documentation and Coding Adjustment CMS continues to refine payments via documentation and coding…Read More

“Quickie Election Rule” – NLRB Loses Round 2 The NLRB has lost another round in the battle over its so-called “Quickie Election Rule.”  The federal court that on May 14, 2012 put a halt to the NLRB’s rule that would have speeded up union elections in the private sector (see our Employment Law News Article) rebuffed the…Read More

After facing significant reimbursement cuts last year, skilled nursing facility (SNF) providers have reason to celebrate after the Centers for Medicare and Medicaid Services (CMS) released the FY 2013 SNF Prospective Payment System (PPS) schedule.  Effective October 1st of this year, SNF providers can expect a 1.8% increase in their PPS reimbursement.  While a modest bump, the…Read More

A July 24, 2012 article in the New York Times counted Louisville, Kentucky as a city that is touting itself as a market for business opportunities in the elder care arena. The article cites the construction of a new eight story commercial office and laboratory building near downtown Louisville as signaling an expansion of one…Read More

In Gister v. American Family Mutual Insurance Company, 2012 WI 86 (July 11, 2012), the Wisconsin Supreme Court held that charitable hospitals in Wisconsin may pursue payment for the medical care provided to Medicaid recipients by filing a lien against the settlement between the patient and the insurance company insuring the liability of the tortfeasor…Read More

Rep. Boustany Introduces Bill to Allow Physician Incentive Payments Meets with Hall Render to Discuss Stark Law Reform On Wednesday, Rep. Charles Boustany, M.D. (R-LA), a retired cardiovascular surgeon, introduced the Aligning Incentives for Better Patient Care Act of 2012 (H.R. 6176), which was co-sponsored by Rep. Tom Price, M.D. (R-GA).  The bill would revise the Stark…Read More