Non-payment for “Never Events”: Coming to a Long-Term Care Provider Near You

Since October 2008, the Centers for Medicare and Medicaid Services (“CMS”) have not paid hospitals for certain hospital-acquired conditions. That is, CMS will not pay for certain conditions that were not present in the patient upon admission. The conditions are, as designated by CMS, conditions that are: (a) high cost or high volume or both, [...]

Federal Government Encourages Health Providers to Coordinate, Then Sues Them For Doing So

Isn’t this great?  It reminds me of this.

Why Should You Have a Compliance Program?

The Patient Protection and Affordable Care Act (“PPACA”) mandates in Sections 6102 and 6401 that a broad range of providers, suppliers, and physicians adopt compliance and ethics programs. By March 23, 2013, skilled nursing facilities and other nursing facilities must have “in operation” a compliance and ethics program that meets the PPACA’s criteria. Although the [...]

IRS Defers Requirement on Reporting Health Plan Coverage Costs

On October 12, 2010, the IRS released a draft Form W-2 for employers for 2011. Employers use Form W-2 to report wages and employee tax withholding. The IRS also announced that it will defer the requirement that employers report the cost of coverage under an employer-sponsored group health plan. Therefore, employer reporting of coverage costs is [...]

Health Care Reform: Nursing Home Transparency and Improvement

Title IV, Subtitle B, of the Patient Protection and Affordable Care Act, entitled Nursing Home Transparency and Improvement, contains several provisions affecting nursing homes. The legislation requires nursing homes to disclose their owners, managers, and the organizational structure to the Secretary of the Department of Health and Human Services (“HHS”), the HHS Inspector General, the [...]