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Health Law Alert
2011: Issue 2 – Focus on Long Term Care
Compliance with the Elder Justice Act's Reporting Requirements: Cautionary Tactics in the Face of Continuing Uncertainty
By: Virginia B. Evans and John S. Linehan
Signed into law on March 23, 2010, as part of the Patient Protection and Affordable Care Act (PPACA), the Elder Justice Act (EJA, or the “Act”) authorizes and imposes a comprehensive range of initiatives aimed at combating elder abuse, neglect, and exploitation. For long-term care providers, one of the most significant features of the EJA is contained in section 6703(b)(3), which adds section 1150B to Title XI of the Social Security Act, to establish notification and reporting requirements aimed at uncovering crimes against care recipients in long-term care facilities.
Click to continue...Final Rule Modifies Civil Money Penalties Process for Nursing Facilities
By: Susan A. Turner
Section 6111 of the Patient Protection and Affordable Care Act (the Affordable Care Act) (Pub. L. 111-148), enacted on March 23, 2010, amended sections 1819(h) and 1919(h) of the Social Security Act by adding specific provisions related to the imposition and collection of civil money penalties (CMPs) when nursing facilities are found, following a survey, to be out of compliance with Medicare and Medicaid participation requirements. The Centers for Medicare & Medicaid Services (CMS) published a final rule [PDF] implementing the CMP provisions on March 18, 2011.
Click to continue...Prior Regulatory Approval of DMEPOS Supplier Defeats FCA Action
A federal court recently awarded partial summary judgment to a nursing home chain and its Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) supplier in a lawsuit filed under the False Claims Act (FCA), based on CMS’s prior determinations that the supplier had complied with applicable DMEPOS supplier standards. See U.S. ex rel. Jamison v. McKesson Corp., 2011 WL 1158945 (N.D. Miss. Mar. 28, 2011). The case highlights the importance of understanding the government’s regulatory oversight of providers and, to the extent possible, using this extensive regulation offensively to refute allegations that a provider submitted false claims for payment.
Click to continue...Update of Maryland’s Health Care Facility Licensing Regulations Under Way
Maryland’s Department of Health and Mental Hygiene (DHMH) recently announced an internal “Task Force on Regulatory Efficiency” to conduct a review of facilities to promote greater transparency, efficiency and effectiveness. The Task Force will review and recommend adjustments to regulations applicable to a broad array of facilities. Details of the initiative, launched April 4, 2011, are available here.
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