Articles and Blogs

The Patient Protection and Affordable Care Act (PPACA) requires all skilled nursing facilities (SNFs) and nursing facilities (NFs) to have an effective compliance and ethics program in place by March 23, 2013.  Unfortunately, the Centers for Medicare & Medicaid Services (CMS) has failed to publish final regulations covering these programs, as required under PPACA, by... READ MORE

Under the Bundled Payments for Care Improvement initiative, organizations will enter into payment arrangements that include financial and performance accountability for episodes of care. The Centers for Medicare & Medicaid Services (CMS) hopes these models may lead to higher quality and more coordinated care at a lower cost to Medicare.   READ MORE

Today, the Centers for Medicare & Medicaid Services (CMS) announced that over 500 organizations will begin participating in the Bundled Payments for Care Improvement initiative. Through this new initiative, made possible by the Affordable Care Act (ACA), CMS will test how bundling payments for episodes of care can result in more coordinated care for... READ MORE

On January 2, 2013, the Department of Health and Human Services (“HHS”) announced that it had reached a settlement with a hospice provider (“Hospice”) arising from potential violations of the Security Rule under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).  HHS learned of the circumstances giving rise to the enforcement action... READ MORE

The Federal Communications Commission (FCC) has just issued a release detailing the establishment of the Healthcare Connect Fund (the “Fund”) to reform and modernize its universal service program for health care.  Recognizing the importance of high-speed data connectedness for quality patient care and burgeoning  health care practices such as telemedicine, the FCC is expanding and reforming its existing Rural Health... READ MORE

The Centers for Medicare & Medicaid Services (CMS) will soon be distributing a free toolkit to nursing facilities, CMS Regional Offices, and State Survey Agencies. Hand in Hand is a high quality training series for nursing homes that emphasizes person-centered care for persons with dementia, as well as the prevention of abuse. Section 6121 of... READ MORE

While hospices are required to ensure that substantially all core hospice services, including nursing services, are performed by hospice employees, hospices have been permitted to utilize contracted staff members to supplement hospice employees during periods of peak patient loads or extraordinary circumstances. The Centers for Medicare & Medicaid Services (CMS) agrees the nation-wide shortage of hospice nurses has... READ MORE

As part of the Patient Protection and Affordable Care Act (PPACA), the Office of the Inspector General (OIG) was mandated to submit a report to Congress evaluating the Nationwide Program for National and State Background Checks on Direct Patient Access Employees of Long Term Care Facilities and Providers (commonly referred to as the “Background... READ MORE

The Office of the Inspector General (OIG) has published their annual Work Plan for 2013. The Work Plan continues to identify compliance risk areas that subject Medicare and Medicaid providers to audit and enforcement initiatives. The Work Plan specifically targets skilled nursing facilities (SNFs), hospices, and home health agencies (HHAs). For all types of... READ MORE

On September 27, 2012 CMS issued revised feeding tube interpretive guidelines to the State Operations Manual (“SOM”). While the actual federal regulation did not change, the SOM changes the interpretive guidelines, which can be found in Appendix PP of the SOM. READ MORE