Nursing Homes Medicare

News & Analysis as of

Administration Joins Courts In Prohibiting Arbitration In Nursing Home Admissions

Within the U.S. Government, the CFPB has gotten most of the attention for trying to regulate consumer arbitration. But this month, the Centers for Medicare & Medicaid Services (CMS) are bumping the CFPB out of the...more

Health Law Insights Newsletter - Issue 13

McCarter & English, LLP’s Health Care Group presents Issue 13 of the Health Law Insights, which discusses the latest legal issues in the health care industry. - Failure to Update Business Associate Agreement Results in...more

CMS Issues Final Rule, Making it Easier to Sue Nursing Facilities

Beginning November 28, 2016, pre-dispute arbitration agreements will no longer be permissible for skilled nursing facilities and nursing facilities participating in the Medicare and Medicaid programs. 42 C.F.R. § 483.70(n). ...more

CMS Issues Final Rule Addressing Improvements in Care, Safety and Consumer Protections for Nursing Home Residents

On September 28, 2016, CMS issued a final rule to improve the care and safety of nursing home residents in long-term care facilities. The new rules are intended to reduce unnecessary hospital readmissions and infections,...more

Pre-Dispute Arbitration Agreements Soon Prohibited for Skilled Nursing Facilities

The Centers for Medicare and Medicaid Services (CMS) published final regulations on October 4, 2016 prohibiting skilled nursing facilities from including arbitration agreements in the resident admission process. The new...more

Arbitration Agreements in Nursing Homes

In a final rule published today in the federal register (“Final Rule”), CMS announced numerous changes to the consolidated Medicare and Medicaid requirements for participation for long term care (LTC) facilities (42 CFR part...more

CMS Federal Nursing Home Arbitration Agreement Ban Is Not Likely to Remain Unchallenged

People in this country have long enjoyed the right to contract. Included with that right is the ability to agree to resolve potential disputes out of court and in arbitration. The Centers for Medicare & Medicaid Services’...more

In Final Rule, CMS Acts to Bar Pre-Dispute Binding Arbitration Agreements With Nursing Home Residents Effective November 28, 2016

On September 28, 2016, the federal Centers for Medicare and Medicaid Services (“CMS”) issued its long-awaited final rule that, among other things, prohibits skilled nursing facilities (“SNFs”) and nursing facilities (“NFs”)...more

U.S. Agency Prohibits Nursing Home Arbitration Agreements

The Centers for Medicare and Medicaid Services (CMS), an agency within the U.S. Health and Human Services Department, has issued a final rule that includes prohibiting nursing homes and other long-term care facilities from...more

CMS Releases Nursing Facility Mega-Rule

The Centers for Medicare and Medicaid (“CMS”) this week released its long-awaited nursing facility “Mega-Rule,” the most comprehensive revision of CMS’s requirements for nursing homes since 1991. CMS said that the new...more

Also In The News - Health Headlines - August 2016 #3

CMS Releases Medicare Outpatient Observation Notice For Public Comment – CMS announced that the public has the opportunity to comment on the Medicare Outpatient Observation Notice (MOON). The MOON is a standardized form...more

CMS Cracks Down On Social Media Abuse By Nursing Home Staff

On August 5th the Centers for Medicare & Medicaid Services (CMS) issued a memorandum to all state survey agencies requiring that during the next standard survey of a nursing home, whether a Traditional or Quality Indicator...more

Kickback Prosecutions Expanding Beyond Drugs and Devices to Care Networks

The DOJ has recently showed some new muscle by applying anti-kickback laws to care facility owners rather than drug manufacturers. The uptick in federal healthcare fraud prosecutions in 2016 has been well-documented, but...more

CMS Adds New Quality Measures to Nursing Home Ratings

On August 10, 2016, the Centers for Medicare & Medicaid Services (CMS) announced that it has incorporated five new quality measures to the calculations for its nursing home Five-Star Quality Ratings. The five measures are now...more

CMS Proposes Fiscal Year 2017 Payment for Skilled Nursing Facilities and Provisions for FY 2019 Value-Based Purchasing...

Overall, the Proposed Rule details CMS’s proposals for SNFs in CMS’s accelerating pace of shifting Medicare payment from volume to value toward the administration’s goals and timeline for moving the Medicare program, and the...more

CMS Adds New Quality Measures To Nursing Home Compare Website

To help residents and their families find a quality Medicare or Medicaid certified nursing home and to encourage nursing homes to achieve high quality by public reporting of quality measures, in 1988 the Centers for Medicare...more

DOJ Targets Nursing Fraud with New Task Forces

On March 30, 2016, the U.S. Department of Justice launched 10 regional task forces targeting “grossly substandard care” in nursing homes and other long-term care facilities across the country. The task forces combine federal,...more

Health Care Advisory: Highlights of the OIG’s 2016 Work Plan

On November 2, 2015, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) issued its Work Plan for Fiscal Year 2016 (“2016 Work Plan”).1 The 2016 Work Plan outlines the areas of...more

CMS Proposes Restrictions on Arbitration Provisions in Nursing Home Resident Agreements

The use of a binding arbitration provision in the pre-admission agreement between a senior living facility and its resident has become quite common. If properly drafted and presented to the resident or his or her...more

Tidbits and Takeaways from OIG’s 2016 Work Plan

The Office of Inspector General for Health and Human Services (“OIG”) recently issued its 2016 Work Plan, which sets the agenda for its auditing and investigation in the year ahead. The broad mandate of the OIG is to...more

OIG Work Plan Series Installment Two - Long Term Care - Nursing Homes, Hospice, and Home Health

In early November 2015, the Department of Health & Human Services’ Office of Inspector General (OIG) released its 2016 Work Plan, which includes projects specific to certain provider types. This alert will focus on the...more

Court Rules that Medicare and Medicaid Payments to Nursing Home Must Continue Pending Jurisdictional Dispute

On October 27, 2015, United States District Judge James S. Moody, Jr. extended a stay of proceedings thereby permitting Bayou Shores SNF, LLC (“Bayou Shores”) to remain viable and continue receiving Medicare and Medicaid...more

The Deeper Dive: Medicare’s Fundamental Shift Toward P4P - What priorities should providers focus on in navigating the changing...

While Medicare’s path toward pay for performance (P4P) has evolved over time, 2015 is proving to be a landmark year. July marked the 50th anniversary of the Medicare program. And in self-described “historic announcements”...more

A Federal Ban on Arbitration Agreements in Nursing Homes? Senators’ Comment on CMS Proposed Rule Ignores Congressional Intent and...

In July, the Centers for Medicare & Medicaid Services (CMS) proposed changes to the requirements for long-term care facilities, including implementation of new restrictions on the use of binding arbitration agreements between...more

Arbitration of Nursing Home Suits: Take Two

Quasi Tort Reform in Nursing Home Litigation Is on the Way! Last fall, I posted a blog about the national trend of including arbitration provisions in nursing home admission agreements. This trend peaked following the...more

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