Husch Blackwell attorneys are presenting at the Colorado Health Care Association and Center for Assisted Living Legal Symposium on elder abuse and financial exploitation on March 12 in Denver.
Healthcare providers are responsible for detecting, preventing and reporting elderly abuse, including financial exploitation. With the enactment of the Affordable Care Act, the reporting requirements of the Elder Justice Act are now in effect.
The U.S. Court of Appeals for the 9th Circuit affirmed a lower court’s findings Feb. 10, 2015, that the acquisition by St. Luke’s Health System (“St. Luke’s”) of Saltzer Medical Group (“Saltzer”), a physician group consisting mostly of primary care physicians, violated Section 7 of the Clayton Act. This is the first case in which the Federal Trade Commission (“FTC”) litigated through trial a challenge to a physician acquisition.
The Department of Labor (“DOL”) published its final rule on Feb. 24, 2015, relating to the definition of “spouse” under the Family and Medical Leave Act (“FMLA”) Regulations. Beginning March 27, 2015, when the final rule becomes effective, the definition of “spouse” for purpose of FMLA leave will include eligible employees in legal same-sex marriages. Prior to this rule change, same-sex partners were only considered spouses if their marriage was recognized in the state where they lived. Under the new rule, the focus shifts to where the marriage was “celebrated.” Accordingly, if the marriage is legal under the law of the state where the marriage was performed or “celebrated,” the same-sex marriage is legal for purposes of the FMLA regardless of state law where the employee lives.
On Friday, February 20, 2014, the Centers for Medicare & Medicaid Services (“CMS”) unveiled its adjustments to Nursing Home Compare, a website many view as the premier tool for evaluating the nation’s nursing homes. CMS hopes the changes will cause nursing homes to make quality improvements, while critics warn that that the information is still unreliable and could confuse consumers who witness a sudden downward change in a facility’s rating. Nearly a third of the nation’s nursing homes experienced lower star ratings as a result of the changes. CMS stated that 1.4 million viewers access the website annually, with 85 percent of users reporting that they found the information they sought regarding nursing homes.
In March 2014, President Obama directed the Secretary of Labor to prepare and propose new FLSA regulations. These new rules were to be announced late last year, but have been repeatedly delayed. Now it appears the new rules will be announced later this month. While the scope of the changes is unknown, it is anticipated the changes will reduce the number of employees who qualify for exempt status.
The Texas Health & Human Services Commission’s (HHSC) final rules regarding physician billing for services provided by an APRN or PA became effective Jan. 1, 2015, and include limitations on such billing arrangements. See 39 Tex. Reg. 9884 (Dec. 19, 2014). The adopted rule requires that a physician billing for services provided by an APRN or PA under the physician’s Medicaid billing number must make a decision regarding the patient’s care or treatment on the same date of service as the billable medical visit and documented that decision in the patient’s record. See Tex. Admin. Code Tit. 1 §354.1062. If a physician billing for such services does not make a decision regarding the patient’s care or treatment on the same date of service, the physician must note on the claim that the services were provided by a supervisee. See Tex. Admin. Code Tit. 1 §354.1001.
Seemingly picking up where we left off in our recent white paper and Advisory Board article, the Obama administration released a 166-page draft plan January 30th intended to drive providers and patients toward a common set of electronic clinical information and a commitment to more fully connected EHR systems by the end of 2017.
On Jan. 26, 2015, Secretary Sylvia M. Burwell announced the goals and a timeline of the U. S. Department of Health & Human Services (“HHS”) to move the Medicare program, and the healthcare system at large, toward paying providers based on quality, rather than quantity, of care they give to patients.
Brian G. Flood of Husch Blackwell LLP‘s Austin office participated in a recent forum on “Managing Fraud and Bribery Risks in the Healthcare Sector.”
The Q&A Forum forms part of a Special Report on Corporate Fraud & Corruption, which appears in the February 2015 issue of Financier Worldwide magazine.
For the Q&A Forum, Financier…
Due diligence is often perceived as a mundane part of the mergers & acquisitions (M&A) process, but its importance in healthcare transactions is critical. Due diligence is one of the first steps of any transaction and involves a buyer undertaking an in-depth examination of the target to evaluate the business and uncover potential issues or liabilities. In the healthcare industry, diligence is especially important considering the heavy regulation of the industry, the unique areas of risk, and the significant liabilities that could be imposed upon a buyer if issues and liabilities are not identified before the transaction closes.
