The Ohio Association of Nonprofit Organizations (“OANO”) recently released the 2014 Ohio Nonprofit Sector Report. This report, which Benesch was pleased to sponsor, provides analyses of recent Form 990 data reported by 501(c)(3) organizations in Ohio with at least $50,000 in revenue. It has a wealth information about the state of, and trends in, the Ohio charitable nonprofit sector including data analysis about the number of organizations serving Ohioans, the different industries in which these organizations operate, expenditure information, as well as aggregate wage and employment information for charitable nonprofit organizations relative organizations in other industries. Continue reading
McKnight’s news stories can be a good source of ideas for quality improvement projects, long-term care attorney Janet K. Feldkamp recently told a webcast audience. Looking at our recent items, I’d say the time is ripe to review CPR policies: Three separate stories emerged last week about a variety of problems — and penalties — related to resuscitation.
Please click here to view the full atricle.
On May 12th, the Office of the Inspector General of the Department of Health and Human Services (OIG) issued a proposed rule which would amend the federal civil monetary penalty (CMP) regulations addressing new CMP authorities created under the Affordable Care Act. The revised regulations would allow for civil penalties, assessments, and exclusion from Medicare for :
- Failure to grant OIG timely access to records;
- ordering or prescribing while excluded;
- making false statements, omissions, or misrepresentations in an enrollment application;
- failure to report and return an overpayment; and
- making or using a false record or statement that is material to a false or fraudulent claim.
Comments on the proposed regulations can be submitted up until July 11, 2014. The proposed rule and instructions for submitting comments can be viewed here—> Proposed CMP Regulatory Revisions
For more information on the revisions to the CMP regulations, Fraud and Abuse, Compliance, Medicare Program Integrity initiatives or related issues, please feel free to contact Ari Markenson or any member of our health care practice group for a further discussion.
Posted in Civil Monetary Penalty, Compliance Programs, Fraud and Abuse, Health Care, Health Care Providers, Medicaid, Medicare, OIG, Program Integrity, Proposed Rule, Regulation, Regulatory Compliance
New York ‘s 2014-2015 budget legislation opens the door for a two-year pilot program allowing private equity firms to own and operate healthcare facilities in the state. The proposed plan would allow for the participation of up to five for-profit corporations with affiliations with at least one academic medical center or teaching hospital, while publicly traded entities and private corporations with more than thirty-five stockholders would be prohibited from participating. The move would represent a shift away from the state’s traditional regulations, which have created a system where almost all hospitals have been operated by non-profit entities.
On February 20, 2014, the US Department of Health and Human Services, Departmental Appeals Board upheld CMS’ revocation of the Medicare provider number of a clinic/group practice.
In Advanced Care Medical Center v CMS (Docket No. C-13-1383/Decision No. CR3124), the DAB, Civil Remedies Division upheld CMS’ revocation of Advanced Care’s Medicare provider number.
The matter began with an investigation by the Office of the Inspector General which revealed that Advanced Care entered into a contract with a doctor, allowing him to bill for services under it’s billing number in exchange for a set reimbursement, and the doctor submitted bills under Petitioner’s billing number. Continue reading
Posted in Certification, Community Based Care, Compliance Programs, DAB Decisions, DHHS, Fraud and Abuse, Health & Human Services, Health Care, Health Care Providers, Medicare, Out-Patient Care, Participation, Physicians, Program Integrity, Provider Enrollment - Medicare, Regulatory Compliance
Many senior care employers are losing sleep over healthcare reform, reimbursement cuts and changing consumer preferences. Balancing cost, compliance and competitive pressures with the quest to provide high quality care has put an increased focus on the workforce. What does quality staffing look like in 2014? A free McKnight’s webcast will sort through facts and myths to help providers better understand what they should be doing to keep themselves at the quality forefront. The featured speaker will be Janet K. Feldkamp, a partner with Benesch Friedlander Coplan & Aronoff. The event begins at 1 p.m. (Eastern Time).
To learn more or sign up for the free event, which is being sponsored by OnShift, click here.
If you have any questions concerning this topic please do not hesitate to contact a member of the Health Care Practice Group.
Janet K. Feldkamp at firstname.lastname@example.org or 614.223.9328
On September 24, 2013, 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-09-12-00350) entitled “Utilization of Medicare Ambulance Transports, 2002-2011″.
The OIG has in the past focused on overutilization of ambulance transportation and identified these services as an area of concern. This recent report found that the overall number of ambulance transport claims during the time period in question increased by 69%, while the total number of beneficiaries during the time period increased by 7%. Further, the OIG also zeroed in on transports to or from independent dialysis facilities (dialysis-related transports) which it found had increased 269%. Continue reading
Posted in Ambulance, Compliance Programs, DHHS, Fraud and Abuse, Health Care, Medicare, OIG, OIG Reports, Regulatory Compliance, Reimbursement, Transportation