This past July, the Federal Communications Commission (“FCC”) released a ruling (the “Ruling”) interpreting the Telephone Consumer Protection Act (“TPCA”) restrictions on certain communications to wireless telephone numbers. The Ruling significantly restricts business’ ability to use auto-dialers and artificial / prerecorded voices for contacting wireless telephone numbers, including via text message (“automated contact system ”), prior to obtaining customer consent. Fortunately for the many health care providers who rely on this type of technology for important patient correspondence such as appointment reminders, the FCC has provided a significant exception for providers’ automated contact systems that meet certain criteria set forth in the Ruling. While the criteria are not overly burdensome, they are numerous and specific, so health care providers with automated contact systems should review them carefully to ensure ongoing compliance with the TPCA.
Following the Ruling, health care providers with automated contact systems must either obtain patient consent prior to using automated contact systems, or be sure that their automated contact system comply with the Ruling. Generally, to be exempt from obtaining prior express consent from patients calls to wireless numbers using automated contact systems:
- must not be charged to patient-recipients;
- must be for specific, health-related purposes;
- must include easy opt-out options; and
- are subject to volume and brevity restrictions.
The Ruling describes in greater detail the steps that health care providers must take to meet the above standards.
The FCC ruling is available here. Contact a member of the Benesch team if you have any questions about your automatic contact system after the FCC’s recent ruling.
Palliative care services are now more accessible to patients with serious and chronic illnesses in the United States. The Mayo Clinic defines palliative care as offering pain and symptom management and emotional and spiritual support when a patient faces a chronic, debilitating or life-threatening illness. Increasingly offered to patients of any age with a range of chronic illnesses such as cancer, multiple sclerosis and Parkinson’s disease, palliative care may be provided at the same time as curative medical regimens to help patients tolerate side effects of disease and treatment, and proceed with everyday life. According to a recent December 22, 2014 Wall Street Journal article, palliative care programs have increased three fold over the past decade. Many hospitals have specialized palliative care programs and 80% of hospitals with 250 beds or more provide such a program.
The provision of palliative care with or without curative treatment can lead increased patient and health care provider satisfaction, equal or better symptom control, less anxiety and depression, less caregiver distress, and potential cost savings. A patient’s quality of life can be enhanced with active and effective pain and symptom management. The need for aggressive pain and symptom management often lead patients to seek out a palliative care program to manage their symptoms during a chronic or terminal illness. Some patients also choose to utilize hospice care towards the end of their life journey after receiving services from a palliative care program. With the better availability of palliative care, those patients seeking pain relief and symptom control at any stage of their chronic or terminal illness care are able to find the services to address their needs including assisting the patient and the family to navigate the often complicated medical system.
The OIG recently made available its 2014 Work Plan. The Plan identifies OIG focus areas and priority projects for the coming year. This post provides a brief summary of many of the new OIG projects for fiscal year 2014 to assist providers in keeping abreast of the latest developments in health care fraud and abuse, compliance, reimbursement, and enforcement activities. Only a small part of the Plan is summarized here. For the entire document, please follow the link below. Continue reading
Posted in Acute Care, Community Based Care, Compliance Programs, Continuing Care, Durable Medical Equipment, Fraud and Abuse, Health Care, Health Care Providers, Hospice, Hospital, OIG, OIG Work Plans, Palliative Care
The Office of the Inspector General (“OIG”) issued a 2014-2018 strategic plan including outlining the visions, goals, and priorities of that office for the upcoming several years. The plan sets forth four goals: 1. Fight fraud, waste and abuse; 2. Promote quality, safety, and value; 3. Secure the future; and 4. Advance excellence and innovation. Each goals is identified with several priority areas that support the stated goal. The report can be found at the OIG’s website http://go.us.gov/WdbV
Posted in Acute Care, Ambulance, Ambulatory Surgery Centers, Anti-Kickback, Assisted Living, Clinical Laboratory, Clinics, Community Based Care, Compliance Programs, Continuing Care, Diagnostic Testing, Disability, Durable Medical Equipment, Fraud and Abuse, General, Health Care, Health Care Providers, Health Care Workers, Health Information Privacy, HIPAA, Home Health, Hospice, Hospital, Intermediate Care Facility, Long Term Care, Long Term Care Hospital, Medicaid, Medicare, Mental Health, Nursing Home, Occupational Therapy, OIG, OIG Reports, OIG Work Plans, Out-Patient Care, Palliative Care, Pharmacy, Physicial Therapy, Physician Assistants, Physicians, Post Acute Care, Primary Care, Regulatory Compliance, Rehabilitation, Rehabilitation Hospital, Residential Care, Senior Housing, Skilled Nursing Facility, Supplier, Transportation
On November 6, 2013, CMS issued Transmittal No. 1311 which instructed Medicare Administrative Contractors (“MACs”) to reject claims for SNF to SNF ambulance transfers that are billed separately under Part B. According to CMS, ambulance transportation and related ambulance services for residents in a Part A stay are included in the SNF PPS rate and may not be billed as Part B services by the supplier. Instead, the SNF discharging the beneficiary to another SNF is responsible for the transportation fees. As such, ambulance providers must seek payment from the transferring SNF. Continue reading
Posted in Ambulance, CMS Transmittals, Continuing Care, Health & Human Services, Health Care, Health Care Providers, Long Term Care, Medicare, Nursing Facility, Nursing Home, Post Acute Care, Program Integrity, Regulatory Compliance, Skilled Nursing Facility, Transportation
The first Survey & Certification memo for nursing facilities was issued for Fiscal Year 2014 on October 1, 2013. S&C 14-01-NH requires nursing facilities to adopt a policy that implements basic life support measures such as basic CPR for residents in accordance with the individual resident’s advance directives. Some nursing facilities have previously adopted a policy that when a resident is found without vital signs and the resident was a full code, the facility called 911 and waited for a response from the emergency personnel. CMS has affirmatively stated that the facility implement CPR when cardiac arrest occurs for residents in accordance with their advance directives and merely waiting for emergency personnel to respond to the 911 call is inadequate. CPR certified staff must be available at all times to provide CPR when necessary. Facilities will be cited under F155 for violating a resident’s right to formulate an advance directive if the facility does not develop and successfully implement policies and procedures to assure that residents will be resuscitated in accordance with their individual advance directives.
You can find a copy of the letter here —> S&C 14-01-NH
For more information on the Survey Letter or related issues, please feel free to contact Janet Feldkamp or any member of our health care practice group for a further discussion.
Posted in Advanced Directives, Certification, Consumers, Continuing Care, Health Care, Health Care Decisions, Health Care Providers, Long Term Care, Medicare, Nursing Facility, Nursing Home, Post Acute Care, Regulatory Compliance, Residential Care, Skilled Nursing Facility, Survey and Certification Letters
In the April 5th Federal Register, the Center for Medicare and Medicaid Services (CMS) proposed new rules relating to immediate jeopardy situations for providers or suppliers that are not Skilled Nursing Facilities (SNFs) or Nursing Facilities (NFs). The proposed rules were published in April of 2013 in the Federal Register and generally apply to the oversight of accrediting organizations, but CMS also proposed a changed to the rule on providers and suppliers, other than SNFs and NFS, with deficiencies. Continue reading
Posted in Acute Care, Certification, Continuing Care, DAB Decisions, DHHS, Health & Human Services, Health Care, Health Care Providers, Home Health, Hospice, Hospital, Intermediate Care Facility, Long Term Care, Medicare, Nursing Facility, Nursing Home, Participation, Post Acute Care, Proposed Rule, Regulation, Regulatory Compliance, Rehabilitation, Rehabilitation Hospital, Residential Care, Skilled Nursing Facility