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Home Health Payment Rule Published

On November 1, 2017, CMS released the Final Rule for the 2018 home health prospective payment system rate update, including the CY 2019 case mix adjustment methodology refinements. CMS also made changes to the Value Based...more

Requirements for Participation Guidance for LTC Surveyors Published

The State Operations Manual Guidance for Long Term Care Surveyors (Appendix PP), effective November 28, 2017, has undergone substantial revision. As a result of regulatory changes, the F-tags for surveys have been renumbered....more

CMS Finalizes Revamped Home Health Agency Conditions of Participation

CMS recently issued revamped home health agency (HHA) conditions of participation (CoPs), strengthening patient confidentiality, patient rights, quality assessment, care and performance standards. The final rule was published...more

HHS OIG Expands Safe Harbors, but Doubles Down with Enhanced Civil Monetary Penalties

The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) published two rules on December 7, 2016, updating certain existing safe harbor regulations, adding new safe harbor rules under...more

CMS Says: No More Arbitration Provisions in LTC Admission Agreements

The Centers for Medicare & Medicaid Services (CMS) has published the final rule for long term care (LTC) facilities with an effective date of November 28, 2016. Among its many proclamations, CMS has ruled that LTC facilities...more

Health Care, Defense and Other Government Contractors Will Face False Claims Act on Implied False Certification Theory

In light of the June 16, 2016, opinion of the United States Supreme Court in Universal Health Services, Inc. v. United States ex. rel. Escobar, government contractors can face liability in certain instances under the federal...more

CMS Relaxes Proposals for Returning Overpayments, but Significant Questions Remain

On Thursday, the Centers for Medicare and Medicaid Services (CMS) published a long awaited final rule that fleshes out the requirement for health care providers and suppliers that participate in Medicare Parts A and B to...more

Baker Donelson Comments on CMS's Proposed Changes to the Stark Regulations - September 2015

The law firm of Baker, Donelson, Bearman, Caldwell & Berkowitz, P.C., sincerely appreciates the opportunity to comment upon the proposed clarifications and changes to the Stark regulations issued by the Centers and Medicare...more

Time to Revisit Your Physician Relationships

On June 9, 2015, the Department of Health and Human Services, Office of Inspector General issued a new Fraud Alert entitled "Physician Compensation Arrangements May Result in Significant Liability" (Alert) in the wake of 12...more

Home and Community-Based Services: Seven Things You Need to Know

Few people have a strong understanding of home and community-based services (HCBS), how they work, how they came about and why they are important. There are a number of reasons why HCBS experts are few and far between. Put...more

Nursing Home Reporting of Reasonable Suspicion of a Crime in a Long Term Care Facility

Nursing facilities, skilled nursing facilities, hospices that provide services in long term care facilities and independent living facilities that provide services for the developmentally disabled ("facilities") are required...more

Nursing Homes Must Abide by HIPAA Rules When Disclosing Deceased Resident PHI

The Health Insurance Portability and Accountability Act (HIPAA) as amended by the Health Information Technology for Economic and Clinical Health Act (HITECH Act) contains the HIPAA Privacy and Security rules....more

8/14/2013  /  GINA , HIPAA , HITECH , Medical Liability , Nursing Homes , PHI

Weigh In with Comments on CMS Proposed Rule for Medicare IRP by June 28

The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule entitled "Medicare Program; Requirements for the Medicare Incentive Reward Program and Provider Enrollment" on April 29, 2013. This proposed rule,...more

Rural Hospital Cardiac Catheterization Lab Cost Savings Program issued favorable OIG Advisory Opinion

On December 31, 2012 the U.S. Department of Health and Human Services Office of Inspector General ("OIG") issued a favorable Advisory Opinion No.12-22 for a hospital cardiology group compensation arrangement that includes a...more

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