Hospice

News & Analysis as of

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

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

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

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

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

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

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

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

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

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

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

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

Florida Federal District Court Dismisses Plaintiff’s Qui Tam Action Against Hospice Providers

On September 22, 2016, the United States District Court for the Middle District of Florida granted defendant hospice providers’ motions to dismiss plaintiff-relator’s claims under the False Claims Act, Florida’s False Claims...more

[Event] Long-Term Care Conference - October 18th, Richmond, VA

Williams Mullen's Long-Term Care Conference will provide health care executives with the latest information on how to mitigate professional liability and regulatory risks; manage employment law matters, including overtime,...more

EndNotes - September 2016 - News for North Carolina's Hospice and Palliative Care Community

Nondiscrimination Final Rule under the ACA Imposes New Requirements on Hospice Agencies - On May 26, 2016, the United States Department of Health and Human Services (HHS), Office of Civil Rights (OCR), issued the...more

Nondiscrimination Final Rule under the ACA Imposes New Requirements on Hospice Agencies

On May 26, 2016, the United States Department of Health and Human Services (HHS), Office of Civil Rights (OCR), issued the “Nondiscrimination in Health Programs and Activities” final rule, implementing Section 1557 of the...more

Corporate Investigations and White Collar Defense - August 2016

Spotlight on the False Claims Act - Why it matters: This month, we review a recent Ninth Circuit case that allowed a qui tam relator’s action against various Medicare Advantage organizations to proceed, holding that the...more

CMS Releases Final Rule Addressing Hospice FY 2017 Wage Index, Payment Rates, and Quality Reporting

On August 5, 2016, CMS released a final rule addressing fiscal year (FY) 2017 updates to the hospice wage index, payment rates, and quality reporting requirements. Of note, the final rule increases hospice payments by 2.1...more

Alabama CON Report

I. Certificate of Need Program - A. AL2016-023, RehabCare Group East, Inc., Birmingham, AL: Proposes to relocate the existing multi-service outpatient rehab center from 100 Shadow Wood Park, Ste. B, Birmingham, Shelby...more

OIG Approves Hospice Payments to Nursing Facility for Dual Eligible Patients Under Medicaid Demonstration Project

On July 20, 2016, the Department of Health and Human Services, Office of Inspector General (OIG) issued a favorable Advisory Opinion (16-08) [PDF] regarding payments from a hospice to a nursing facility in which a dual...more

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