CMS announced the increase on April 1, 2019: Today, the Centers for Medicare & Medicaid Services (CMS) finalized updates that will take significant steps in continuing the Trump administration’s efforts to increase competition among Medicare Advantage and Part D plans so patients get higher quality care at lower costs. These changes will increase plan choices and benefits, and include important actions to address the opioid crisis. “Today’s changes give plans the ability to be innovative … [Read more...] about CMS Increases Rates For Medicare Advantage Payments
The Revised Appendix Q
On March 5, 2019, CMS sent a memo to the State Survey Agencies regarding revisions in Appendix Q, Guidance on Immediate Jeopardy. Here is a summary of the key changes: Likelihood instead of potential: This changes the previous version in that it clarifies that rather than a "potential for serious harm," in order to cite IJ in situations where residents or patients have not suffered serious injury, harm, impairment or death, the surveyor is to determine whether the noncompliance creates a … [Read more...] about The Revised Appendix Q
DEA Registrants Beware!
The Texas Medical Board is reporting that scammers posing as DEA agents are targeting physicians, pharmacies, and individuals for the purpose of extortion. The United States Drug Enforcement Administration (DEA) is aware that registrants are receiving telephone calls and emails by criminals identifying themselves as DEA employees or other law enforcement personnel. The criminals mask their telephone number on caller ID by showing the DEA Registration Support 800 number. Please be aware … [Read more...] about DEA Registrants Beware!
DOL Proposes New Rule Regarding Calculation of Overtime Pay Rates
The Proposed Rule was published on Friday, March 29, 20 and is available here. The proposed rule is designed to help employers who provide more perks to employees instead of raises in amounts of salaries. The existing "regular rate" rules, which have not been updated in 50 years discourage the practice: “Under current rules, employers are discouraged from offering more perks to their employees, as those perks may be vaguely defined in calculating an employees’ regular rate of … [Read more...] about DOL Proposes New Rule Regarding Calculation of Overtime Pay Rates
Law Enforcement & the Intellectually Disabled
In Louisiana, law enforcement locked up a 16-year-old because all options for services had been exhausted: What we do know is prosecutors knew the 16-year-old Cadarius was not competent to stand trial, but they still charged him as an adult. The move, according to Judge Jenifer Clason, who handles both juvenile and adult cases in Claiborne Parish, was because “we were able to make sure he was safe and properly cared for.” A very sad story. … [Read more...] about Law Enforcement & the Intellectually Disabled
Guilty Plea in HIPAA Criminal Case
A former patient information coordinator of a health care system pleaded guilty to a count of unlawfully disclosing patient information: "Specifically, on Aug 11, 2017, Kalina unlawfully disclosed personal gynecological health information related to two such patients, with the intent to cause those individuals embarrassment and mental distress," the Justice Department statement says. Apparently, her motive was retaliation against employees who worked at her previous employment from … [Read more...] about Guilty Plea in HIPAA Criminal Case
Oklahoma Attorney General’s Opioid Epidemic Case Not Continued
The Oklahoma Attorney General has sued three drugmakers in a multi-billion dollar lawsuit alleging that they contributed to "the opioid abuse and overdose epidemic in the state." The drugmakers requested a continuance from a May 2019 trial setting based on the state's delay in providing 1.6 million pages of records critical to one of the defendant's defense. The court has denied the request to continue the case to a later date. … [Read more...] about Oklahoma Attorney General’s Opioid Epidemic Case Not Continued
Calls for Reform in Response to Alleged Nursing Home Abuses
Congressional hearings were recently held regarding alleged nursing home abuses. Sen. Charles Grassley (R-IA) — head of the powerful Senate Committee on Finance, and a longtime nursing home critic — convened the hearing, and said SNF reform would be a “top priority” during his tenure. He said he wants to crackdown on nursing home abuse cases that never get reported to law enforcement and fix weaknesses in the five-star rating system. One of the top officials for the largest nursing home … [Read more...] about Calls for Reform in Response to Alleged Nursing Home Abuses
Calls in Texas for Medicaid Expansion
Health care advocates gathered at the Texas Capitol calling for the expansion of Medicaid citing the number of uninsured Texans. The participants called for a state-wide ballot to amend the Texas Constitution regarding the issue. There are a bill and a Senate Joint Resolution supporting such a measure: At the rally, state Sen. Nathan Johnson, D-Dallas, said Texas should follow the lead of other states in expanding Medicaid. Johnson said it’s time that Texas lawmakers looked … [Read more...] about Calls in Texas for Medicaid Expansion
Pregnancy Discrimination and Lifting Restrictions
The 5th circuit has affirmed a ruling in favor of an employer who did not accommodate a pregnant employee by exempting her from lifting and terminated her for the inability to do her job. The Pregnancy Discrimination Act does not specifically require employers to so accommodate, but if other employees are allowed such exemptions for physical reasons, a pregnant employee can't be treated differently from them. In this particular instance, the court found that there was no evidence that … [Read more...] about Pregnancy Discrimination and Lifting Restrictions