Quality Assurance Programs

News & Analysis as of

CMS Issues Proposed Rule Significantly Modifying the Requirements for Long-Term Care Facilities Participating in the Medicare and...

On July 16, 2015, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule comprehensively updating and extensively revising the requirements for participation for long term care (“LTC”) facilities...more

How Healthy is Your Hotline? Key Takeways to Managing Your Third Party Call Center and Optimizing that Relationship to the Fullest

With more and more public companies engaging third party call centers to “check” the whistleblower program box (as they must), expectations for these call center are exceedingly high, while visibility into the day to day...more

Why Getting FHA’s Loan Servicing Rules 'Right' Matters

In recent years, servicing U.S. Federal Housing Administration- insured loans has become risky business. The U.S. Department of Housing and Urban Development has heightened its monitoring and enforcement, with servicers...more

After Almost 25 Years--New Long-Term Care Regs: An Impressive and Costly Undertaking

On July 16, 2015, CMS released its long-awaited proposed changes for Medicare/Medicaid participation by long-term care (“LTC”) facilities. The new regulations represent the first comprehensive change to the requirements since...more

Impending Deadline: CMS Issues Proposed Rule Reform for Long Term Care Facilities – Part 3 of 4

On July 16, 2015, the Federal Register published Centers for Medicare and Medicaid Services’ (CMS) proposed rule to reform the requirements for Long Term Care Facilities participating in Medicare and Medicaid. CMS will be...more

CMS Proposes Sweeping Changes for Nursing Home Oversight

On July 16, 2015, the Center for Medicare and Medicaid Services (“CMS”) published a Proposed Rule with new standards that will have a sweeping effect on the long-term care industry. This new Rule is the first comprehensive...more

FHA Attempt To Provide New Guidance: Too Little, Too Late?

On June 18, the Federal Housing Administration provided lenders with a new Defect Taxonomy for Single Family Housing Loans, or Loan Quality Assessment Methodology. It has been working on the new taxonomy for almost a year,...more

CMS Issues Proposed Rule Revising Long-Term Care Facility Requirements

On July 16, 2015, the Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to revise the requirements long-term care facilities must meet to participate in the...more

New CMS Proposed Rule Revises Long-Term Care Facility Requirements for Medicare and Medicaid Program Participation

On July 13, 2015, the Centers for Medicare & Medicaid (CMS) issued a long-awaited proposed rule (Proposed Rule) that would revise the requirements that long-term care (LTC) facilities must meet to participate in the Medicare...more

CMS Call: National Partnership to Improve Dementia Care and QAPI (June 16)

On June 16, CMS is holding a call on the National Partnership to Improve Dementia Care and Quality Assurance and Performance Improvement (QAPI). The target audience for the call is consumer and advocacy groups, nursing home...more

FTC and DOJ: The PTO’s Efforts to Enhance Patent Quality Will Promote Competition, Innovation and Consumer Welfare

On May 6, 2015, the U.S. Department of Justice (“DOJ”) and U.S. Federal Trade Commission (“FTC”) submitted public comments to the U.S. Patent and Trademark Office (“PTO”) commending the PTO for its efforts to enhance patent...more

An In-Depth Look at USPTO Patent Quality Problems

The comment period for the USPTO’s proposed patent quality initiatives is open until May 6, 2015, and the Office of Inspector General for the Commerce Department has given stakeholders plenty to think about in its final...more

USPTO Seeks Input on Patent Quality

As announced in a February 5, 2015 Federal Register Notice, the USPTO is launching an enhanced quality initiative that includes a request for public comment on certain proposals and a two-day “Quality Summit” to be held March...more

OIG Questions Potentially Duplicative Hospital Quality Improvement Efforts

The OIG recently issued a report that examined the extent to which Quality Improvement Organizations (QIOs) duplicate other CMS hospital quality improvement efforts, particularly Hospital Engagement Networks (HENs) and the...more

Maintaining Privilege for Quality Assurance Performance Improvement (QAPI) Documents and Reports*

Introduction to QAPI - Pursuant to § 6201(c) of the Patient Protection and Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services (CMS) have issued interim guidance governing the implementation of...more

EPA Issues Final Rule on Third Party Quality Assurance of RINs

On July 2, 2014, EPA issued a final rule outlining the elements of a voluntary third party quality assurance program to ensure the validity of renewable identification numbers (RIN) petroleum refiners use to confirm...more

Worthless Services: Giving Nothing Can Cost You a Lot Under the False Claims Act

Numerous courts have recognized that knowingly billing the federal government for “worthless services” may be a violation of the False Claims Act (FCA). Recently, an Illinois nursing home learned how costly worthless services...more

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