Articles and Blogs

A recent court decision had highlighted two issues on the cutting edge of health care and False Claims Act (“FCA”) law. Both address what happens in the transition from health care advice to health care litigation. The first is the application of the attorney client privilege and the advice of counsel defense. The second is... READ MORE

Subject to various exceptions, a covered skilled nursing facility (“SNF”) stay must initiate within 30 days of a qualifying hospital stay.  In some cases where it is medically predictable that an individual will require a covered level of SNF care within a determinable time frame, that same individual may also have a need for a covered... READ MORE

by David B. Honig and Brian C. Betner CMS Announces Further Delay of Repayment Rule To be published in the February 17, 2015 Federal Register, CMS has extended its deadline for finalizing the Affordable Care Act’s (“ACA”) 60-day payback rule. This is the rule that requires a Medicare or Medicaid provider to return an identified overpayment within... READ MORE

On February 12, CMS hosted an Open Door Forum on the upcoming changes to the Nursing Home Compare Five-Star rating system.  These changes will be effective on February 20th.  Nursing facilities will be able to privately view their revised ratings by mid-morning on Friday, February 13, via their MDS portal login. The updated scoring system may... READ MORE

On August 25, 2014, CMS issued a survey transmittal regarding the need for nursing homes to complete a discharge assessment when a resident transfers from a SNF and/or NF certified bed to a non-certified bed in the same facility.  CMS issued this transmittal to reinforce to facilities that discharge assessments are critical to ensure the... READ MORE

On May 16, 2014, CMS issued a Survey and Certification Transmittal (“Transmittal”) to the state survey agency directors providing infomation on how Medicare and Medicaid certifed long-term care facilities may obtain an extension of time for the installation of automatic sprinkler sytems.  The Transmittal sets forth the procedures on how a nursing home may seek an... 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. READ MORE

Effective January 31, 2014, the Centers for Medicare & Medicaid Services (“CMS”) has issued a temporary moratoria for the enrollment of home health agencies in Fort Lauderdale, Florida; Detroit, Michigan; Dallas, Texas; and Houston, Texas.  CMS also announced it is extending the current enrollment moratoria in Chicago, Illinois and Miami, Florida for another six... READ MORE

Beginning October 1, 2013, a skilled nursing facility (“SNF”), a nursing facility (“NF”) or a dually-certified SNF/NF will be permitted to request an independent informal dispute resolution (“IIDR”) for all federal deficiencies cited on its standard or complaint survey (CMS-2567) that are subject to the imposition, collection and escrow of civil money penalties (“CMPs”)... READ MORE

The House of Representatives recently proposed legislation that would bundle payments for post-acute care services and create penalties for readmissions to Medicare-certified nursing homes. The proposed legislation would also reduce the annual market basket index for Skilled Nursing Services. READ MORE