For an example of how whistleblowers and the False Claims Act interact, read this article, Home Health Care Industry Reels from Medicare Scandal. Whistleblowers can bring qui tam lawsuits against providers and benefit hugely. In this particular case, the whistleblower benefits as follows: The False Claims Act permits individuals to file qui tam lawsuits against companies that defraud the government. Liable companies pay as much as three times the government's losses plus penalties for … [Read more...] about The False Claims Act–A Significant Hammer!
More Money for Doctors Reporting Quality of Care Data
Physicians who provide care to Medicare patients with chronic conditions will have an incentive to do more paperwork. The Kaiser Network reports that the Centers for Medicare and Medicaid Services will begin a three-year pilot program that will pay physicians to report quality of care data. An excerpt: The three-year program will begin next year in 800 small- or medium-sized practices in Arkansas, California, Massachusetts and Utah. During the first year, physicians will be paid for … [Read more...] about More Money for Doctors Reporting Quality of Care Data
Provider Letters: Incident Reporting and Provider/Survey Conference
The Texas Department of Aging and Disability Services (DADS) issued a provider letter to Licensed Nursing Facilities, Medicare/Medicaid-certified Nursing Facilities, and Skilled Nursing Facilities about guidelines for reporting incidents. Superseding guidelines dated July 14, 2000, the revised guidelines require any facility staffer who believes a resident has been abused, neglected, or exploited by another staffer to report it, pursuant to Health and Safety Code §242.122 and 40 Texas … [Read more...] about Provider Letters: Incident Reporting and Provider/Survey Conference
Disaster Preparation At TexasOnline
Hopefully this hurricane season won't be as devastating as the last, but it's good to be prepared. Texas providers (and all residents) should visit the disaster preparation resource page at TexasOnline to stay up-to-date on current news and tips. You'll find links to organizations and agencies that specialize in preparing for disasters, including the Federal Emergency Management Agency and American Red Cross. There are links to state and local government agencies and organizations, and … [Read more...] about Disaster Preparation At TexasOnline
OIG Releases Report on Nursing Homes’ Response to Hurricanes
The Office of Inspector General (OIG) of the U.S. Department Health and Human Services has released a report titled, "Nursing Home Emergency Preparedness and Response During Recent Hurricanes." OIG reviewed 20 nursing homes for the study. According to the report, 94 percent of nursing homes met government guidelines for emergency plans, and 80 percent met guidelines for sufficient emergency training in 2004-2005. However, nursing homes didn't always follow the plans. For example, 5 of the … [Read more...] about OIG Releases Report on Nursing Homes’ Response to Hurricanes
Provider Letter: 211 System
The Texas Department of Aging and Disability Services (DADS) has issued a provider letter (July 17) to Home and Community Support Services Agencies (HCSSA) and Adult Day Care Facilities (ADC) on using the 211 system. The 211 system is a telephone number that connects callers to local health and human services agencies. People looking for social service assistance for food, housing, education, legal help, child care, physical and mental health, financial support, transportation, or emergencies … [Read more...] about Provider Letter: 211 System
HIPAA and Emergency Preparedness
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects individuals' Private Health Information (PHI) held by "covered entities," like health plans, health care providers, and health care clearinghouses, and regulates the use and disclosure of PHI. In order to help emergency preparedness and recovery planners stay in compliance with HIPPA while accessing and using protected health information for the disabled, the U.S. Department of Health and Human Services (HHS) … [Read more...] about HIPAA and Emergency Preparedness
Long Term Care Providers Prepare for Disasters
Because of nightmarish stories like this one, long term care providers are doing more to prepare for disasters, natural and man-made. An organization called Mather LifeWays Institute created a program called PREPARE to train long term care providers in preparing for disasters and public health emergencies. (Senior Journal) To learn more about PREPARE, see the press release. More than 60 percent of Hurricane Katrina victims were elderly, according to the Louisiana Department of Health. A … [Read more...] about Long Term Care Providers Prepare for Disasters
Senate Committee Asks CMS to Investigate QIOs
Concerned about executives' salaries and perks, the Senate Committee on Finance has asked the Centers for Medicare and Medicaid Services (CMS) to investigate Medicare Quality Improvement Organizations (QIOs) for effectiveness and improprieties. (Medical News Today) The call for an investigation was likely prompted by the American Health Quality Association's request for more funding and broadened responsibilities. According to the Kaiser Network, CMS currently pays $300 million per year to … [Read more...] about Senate Committee Asks CMS to Investigate QIOs
Mandatory Background Checks for LTC Employees in Michigan
In a move designed to improve standards in long term care facilities, Michigan Governor Jennifer M. Granholm signed a measure earlier this year that requires nursing homes and other assisted living facilities to conduct criminal background checks on prospective employees, the Michigan Long Term Care Partnership Workforce Background Check. (WILX News) At the web site, Michigan Long Term Care Partnership, you'll find the text of the bill, legal guides, and information on the background check … [Read more...] about Mandatory Background Checks for LTC Employees in Michigan