News & Analysis as of

Hospice

FCA Deeper Dive: Objective Falsity and Medical Necessity Cases

by Bass, Berry & Sims PLC on

The FCA continues to be the federal government’s primary civil enforcement tool for investigating allegations that healthcare providers or government contractors defrauded the federal government. In the coming weeks, we will...more

CMS Proposes Rule to Update the Hospice Wage Index and Payment Rates and Discusses Hospice Quality Reporting Requirements

by King & Spalding on

On April 27, 2017, CMS released a proposed rule (the Proposed Rule) that would update the hospice wage index, payment rates and cap amount for fiscal year (FY) 2018. It also provides an update with respect to quality...more

Tennessee CON Report

I. February and April 2017—Tennessee Certificate of Need Meetings - The agency approved the following applications during the February and April meetings. A. Consent Agenda 1. Walgreens Infusion and...more

CMS Proposes FY 2018 Update to Medicare Hospice Payment Rules; Solicits Ideas for Hospice Program Improvements

by Reed Smith on

CMS has published a proposed rule to establish fiscal year (FY) 2018 Medicare hospice reimbursement rates, update hospice quality programs, and request public input on ways to improve the Medicare hospice program. The...more

Healthcare Fraud and Abuse Review 2016

by Bass, Berry & Sims PLC on

Bass, Berry & Sims is pleased to announce the release of its fifth annual Healthcare Fraud and Abuse Review 2016. The Review, compiled by the firm’s Healthcare Fraud Task Force, is an industry-leading guide to healthcare...more

Merger and Acquisition Activity in the Rehabilitation, Home Health and Hospice Sectors Increased in 2016, But Will this Trend...

Since 2014, there has been a steady increase in mergers and acquisitions in the Rehabilitation sector, with a total of 40 deals announced in 2016. This is almost double the number of deals in 2014 (a total of 21), and...more

Representatives Introduce Medicare Patient Access to Hospice Act

by Arnall Golden Gregory LLP on

On March 1, 2017, Representatives Lynn Jenkins (R-KS-2) and Mike Thompson (D-CA-5) introduced the Medicare Patient Access to Hospice Act, H.R. 1284, to the 115th Congress. The bill was referred to the Committee on Ways and...more

North Carolina CON Activity and Opportunity Report

by Williams Mullen on

February 2017 was a busy month for Certificate of Need (CON) in North Carolina, and opportunities will continue to extend across the calendar year and into 2018. OR/Surgery Center Activity - In February, new...more

Proof by Proxy in FCA Suits? District Court Says It Depends

by Morgan Lewis on

Admissibility of statistical sampling to prove liability in FCA suit is fact dependent. In a February 14, 2017 decision, the Fourth Circuit declined to rule on the question of whether statistical sampling can be used to...more

Fourth Circuit Takes a Pass on Statistical Sampling, Finds DOJ's Settlement Veto Authority Unreviewable

by Bass, Berry & Sims PLC on

After granting the relators’ petition for an interlocutory review of the district court’s rejection of the use of statistical sampling to establish FCA liability, the Fourth Circuit ultimately declined to reach that issue in...more

False Claims Act Alert: Fourth Circuit Punts on Sampling and Extrapolation

by Hogan Lovells on

Tuesday, the Fourth Circuit Court of Appeals ruled in the interlocutory appeal in United States ex rel. Michaels v. Agape Senior Community, Inc.. In an opinion considering two significant questions arising under the qui tam...more

Automated Drug Dispensing

Despite its plain text, the California Board of Pharmacy (the “BoP”) has adopted an interpretation of state statute requiring stocked removable pockets for automated drug dispensing systems (“ADDS”) to be transported to and...more

OIG Report Indicates Areas of Hospice Fraud Vulnerability and Issues a Warning to Hospice Providers

by Ruder Ware on

The HHS Office of Inspector General recently released a report indicating deficiencies in hospice election statements and physician certification of patient eligibility for hospice care. Medicare hospice care provides help...more

MedPAC Votes on Medicare Payment Rate Sufficiency

by King & Spalding on

On January 12, 2017, Medicare Payment Advisory Commission (MedPAC) members unanimously voted to maintain Medicare’s existing updates (i.e., maintain the increases Congress and the HHS Secretary have already established) to...more

“Should Auld Acquaintance Be Forgot” - Performant to Initiate Home Health, Hospice, and DME Audits in 2017

The final quarter of 2016 ended with the Centers for Medicare & Medicaid Services (CMS) announcing Performant Recovery, Inc. (Performant) as the new national Recovery Audit Contractor (RAC) to focus solely on Home Health,...more

Health Update - December 2016

Balancing Gene Therapy’s Promise and Price - Editor’s Note: Exciting advances in science have led to developing treatment breakthroughs, such as gene scripting therapies, that could represent the first potential cures...more

Cal/OSHA Adopts First in the Nation Standard on Workplace Violence Prevention for Healthcare Employers

by Littler on

National research indicates that health care workers are at a substantially higher risk of workplace violence than the average worker in another industry. According to the federal Occupational Safety and Health...more

OIG FY 2017 Work Plan Released: New Areas of Focus for Skilled Nursing Facilities, Hospices, and Home Health Agencies

by Arnall Golden Gregory LLP on

In early November, the Office of Inspector General (OIG) released its 2017 Fiscal Year Work Plan, which summarizes new and ongoing reviews and activities that OIG plans to pursue with respect to Health and Human Services...more

OIG Releases 2017 Work Plan

On November 10, 2016, the Office of Inspector General (“the OIG”) of the U.S. Department of Health and Human Services (“DHHS”) is charged with ensuring the integrity of more than 100 programs administered by DHHS, including...more

Massachusetts Licensure of Hospice Programs Proposed Regulations – Key Take-Aways

Last week, the Massachusetts Department of Public Health issued another round of proposed amendments to its regulations, continuing the Baker Administration’s regulatory reform efforts. Today, we take a closer look at the...more

Massachusetts Regulatory Overhaul Continues

At Public Health Council meeting on November 9, 2016, the Massachusetts Department of Public Health (DPH) released yet another round of proposed regulatory amendments. On deck were regulations concerning Long Term Care...more

CA Nears Adoption of New Workplace Violence Regulations for Health Care Employers, Home Health Providers, and Emergency Responders

by Seyfarth Shaw LLP on

Seyfarth Synopsis: The California Division of Occupational Safety & Health Standards Board approved last week its regulations on Workplace Violence Prevention in Health Care. The California Division of Occupational...more

OIG Examines Compliance with Hospice Election Statement, Terminal Illness Certification Requirements

by Reed Smith on

A recent OIG report examined whether hospices are meeting all requirements associated with the election statement that Medicare beneficiaries sign when they choose hospice care, and whether physicians are meeting all...more

CMS Delays Stricter Reviews of Medicare Home Care Claims

by King & Spalding on

CMS recently announced a delay in the broad implementation of a stricter review program for Medicare home care claims that launched on a demonstration basis on August 3, 2016. CMS began the demonstration program to test...more

CMS to Scrutinize Hospice Election Statements, Physician Certifications

by Arnall Golden Gregory LLP on

As a result of an Office of Inspector General (OIG) report released in September 2016, hospice providers can expect increased survey focus on the content of their hospice election forms and on physician certifications of...more

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