Author Archives: Ari J. Markenson, JD, MPH

Spring Cleaning – Dust Off Your Compliance Program Manual and Take Some Practical Steps to Reinvigorate Your Program.

Compliance program fatigue is nothing new. Over at least the last 15 years, health care organizations have jumped in head first, put together detailed manuals and taken the plunge. However, reimbursement cuts, quality initiatives, RACs, ZPICs, whistleblowers, physical plant renovations and simply significant industry challenges got in the way of sustaining an efficient and effective compliance effort. Health care organizations have also become desensitized to the barrage of compliance education, enforcement press releases, audits and reviews and other shock-value communications on the importance of regulatory compliance. In that vein, this very article may get lost in the shuffle, although, we hope it doesn’t.

An efficient and effective compliance effort with your organization is extremely important, if only as an insurance policy against government scrutiny. Additionally, the Patient Protection and Affordable Care Act of 2010, H.R. 3590 (“ACA”) includes requirements that CMS implement mandatory compliance program requirements for all providers and suppliers. In a distinct section of ACA, nursing home mandatory compliance programs were given a specific implementation timeline. Continue reading

OIG Report: CMS Needs to Provide More Oversight of HHA Program Integrity Efforts

On December 19, 2012, the US Department of Health and Human Services Office of the Inspector General’s (OIG) Office of Evaluation and Inspections (OEI) issued a report (OEI-04-11-00220) entitled “CMS and Contractor Oversight of Home Health Agencies”.

The OIG has consistently identified home health care as an area of concern and it believes home health care is “particularly vulnerable to fraud, waste, and abuse.” Additionally, the OIG has, in other studies it conducted, found vulnerabilities in CMS contractors’ efforts to identify and investigate potential fraud and abuse in home health, as well as limitations in CMS’s oversight of contractors. Continue reading

Connect with Benesch’s Health Care Practice at the Capital Roundtable – Private Equity Investing In Healthcare Services Companies Conference, November 15, 2012

Members of our Health Care Practice will be attending and speaking at the Capital Roundtable – Private Equity Investing In Healthcare Services Companies Conference, November 15, 2012 in New York City.

Alan E. Schabes will be a panel member in a session entitled –  Due Diligence, Deal Structuring, Pricing, & Exits — Four Top Deal Professionals Explain How They Identify & Navigate the Unique Issues of Healthcare Services Deals at 2:40PM

Frank Carsonie will be moderating a session entitled – Healthcare IT – Four Experts Explain Why They Think This Segment Will Lead the Industry’s Growth for Years to Come at 4:40PM

Ari J. Markenson, J.D., M.P.H. will be attending the conference. Continue reading

OIG: Hospice Activities in the 2013 Work Plan

On October 2, 2012, The U.S. Department of Health and Human Services Office of the Inspector General (“OIG”) released its Work Plan for 2013.  The OIG releases its work plan for each year in advance of the coming year. The work plan provides stakeholders in the health care industry with a broad overview of the OIG’s activities in the coming year as they relate to its enforcement priorities and issues it will review and evaluate during that fiscal year. This client alert is one in a series of alerts that will outline the OIG’s activities, as discussed in the 2013 Work Plan, for a specific industry sector – Hospice.

The OIG’s activities relating to Hospice for 2013 are focused on two issues that generally involved hospice –nursing home relationships. The following is a summary of each of the issues and what the OIG is focusing on. Continue reading