GreisGuide to LTACHs » Articles

HHS Puts Industry on Notice: OCR is Serious About HIPAA Enforcement

Jason Greis — Thu, 03 Mar 2011 04:22:21 +0000

On Feb. 22, 2011, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced that it had issued a civil money penalty (CMP) of $4.3 million against Cignet Health of Prince George’s County, MD., the first imposition of a CMP by OCR for a violation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule. Two days later, HHS announced that General Hospital Corporation and Massachusetts General Physicians Organization, Inc., collectively referred to as Mass General, agreed to pay $1 million to settle potential violations of the HIPAA Privacy Rule. Read More...

CMS Rule Expands Long-Term Care Facility Administrators’ Responsibility to Report Facility Closures

Jason Greis — Thu, 03 Mar 2011 04:11:37 +0000

On February 18, 2011, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule (Interim Rule) implementing Section 6113 of the Patient Protection and Affordable Care Act (PPACA). The Interim Rule, which becomes effective March 23, 2011, requires administrators of long-term care facilities (LTCF), including skilled nursing facilities (SNF) eligible for reimbursement under Medicare and nursing facilities (NF) eligible for reimbursement under Medicaid, to submit prior written notification of an impending LTCF closure to the Secretary of the U.S. Department of Health and Human Services (Secretary), the state’s long-term care ombudsman and residents of the facility and their legal representatives or other responsible parties. LTCF administrators that do not comply with the new notice requirements may face sanctions, including civil monetary penalties of up to $100,000 and exclusion from participation in Federal health care programs. In addition, LTCFs must have related policies in place to avoid being cited for survey deficiencies. Read More...

Kindred Healthcare Announces RehabCare Group Merger

Jason Greis — Mon, 14 Feb 2011 03:00:03 +0000

On February 8, 2011, Kindred Healthcare, Inc. (“Kindred”) and RehabCare Group, Inc. (“RehabCare”) jointly announced the signing of a definitive merger agreement under which Kindred will acquire RehabCare for an estimated $35 per share, which includes $26 per share in cash and 0.471 shares of Kindred common stock. The transaction was unanimously approved by the Boards of both Kindred and RehabCare and is expected to close at the end of the second quarter, pending approval from the shareholders of both companies and receipt of antitrust approval. Read More...

GAO Report Highlights Differences in LTACH Oversight Standards in Response to Senate Finance Committee Investigation

Jason Greis — Sun, 09 Jan 2011 05:27:16 +0000

On December 22, 2010, the Government Accountability Office (GAO) released a report (Report) highlighting key differences in Federal oversight standards among long-term acute care hospitals (LTACHs) and certain other classes of hospitals and skilled nursing facilities. The Report was prepared in response to the Senate Finance Committee’s initiation of a formal investigation in March 2010 after a February 10, 2010 New York Times article described patient deaths and allegations of substandard patient care at one of the nation’s largest LTACH providers. Read More...

NCQA Releases Draft Criteria for Accountable Care Organizations (ACOs)

Jason Greis — Wed, 10 Nov 2010 02:02:05 +0000

The National Committee for Quality Assurance (NCQA), a private, not-for-profit organization that accredits and certifies health plans and other healthcare related organizations published on Oct. 19, 2010, its 2011 Draft Accountable Care Organizations Criteria. The draft criteria describe the standards NCQA believes ACOs should meet in order to ensure that an ACO has the infrastructure necessary to function as an accountable entity and achieve improvements in quality and reductions in costs. The draft criteria were developed with the guidance of a multistakeholder Accountable Care Organization Task Force assembled by NCQA. Read More...

CMS Issues Stark Act Voluntary Self-Referral Disclosure Protocol – 9 Key Concepts

Jason Greis — Sun, 17 Oct 2010 18:56:43 +0000

PPACA requires the OIG to establish a protocol for healthcare providers and suppliers to disclose actual or potential violations of the Stark Act. Under the Stark Act, healthcare providers and suppliers may not refer patients to any entity for certain services if the physician has a financial relationship with that entity, unless an exception for such referral applies. On Sept. 23, 2010, CMS released its self-referral disclosure protocol (SRDP). The SRDP provides guidance for healthcare providers and suppliers to self-report actual or potential violations of the Stark Act in exchange for potentially (although not guaranteed) informal and more lenient settlement proceedings. Providers and suppliers should be cautious in self-disclosing through the SRDP. This article highlights nine key concepts and considerations regarding the SRDP.

Health Reform: Is the Hospital Industry Misapplying Congressional Intent?

Jason Greis — Thu, 14 Oct 2010 03:15:21 +0000

Thunder rolled down from Capitol Hill last week when Sen. Charles Grassley (R–Iowa) claimed that certain hospital systems and associations were misapplying the intent of Section 501(r)(5)(B) that prohibits the use of gross charges under the Patient Protection and Affordable Care Act. In their comments to the IRS regarding implementing regulations, the American Hospital Association (AHA) urged the IRS to apply a “gross charges” basis to charge those who do not qualify for financial assistance, and to use it as a starting place for calculating assistance to those who do. Read More...

ACOs and the Shared Savings Program – Part II: Unanswered Questions

Jason Greis — Wed, 13 Oct 2010 00:35:32 +0000

In addition to the numerous misconceptions about Accountable Care Organizations (ACOs) and the Shared Savings Program, there are a number of unknowns regarding implementation, including permitted legal structures, payment amounts, and performance measurement. This article identifies and discusses some of the more significant unanswered questions about ACOs and the Shared Savings Program. Read More...

ACOs and the Shared Savings Program: Some Common Misconceptions

Jason Greis — Sat, 02 Oct 2010 17:37:41 +0000

Section 3022 of the Patient Protection and Accountable Care Act (the Act) creates the Shared Savings Program for Medicare. Under the Shared Savings Program, which is to take effect no later than Jan. 1, 2012, Accountable Care Organizations (ACOs) that meet certain requirements established by the Secretary of Health and Human Services will be eligible to receive additional payments from Medicare where certain performance guidelines are met and cost-savings targets are achieved. The amount of the additional payment will be a percentage of the difference between the estimated per capita Medicare expenditures for patients assigned to the ACO and the cost-savings per capita Medicare expenditures threshold. Read More...

Kindred Continues Expansion through Acquisitions

Jason Greis — Sun, 29 Aug 2010 01:03:45 +0000

Kindred Healthcare has moved to expand its market presence in key cluster markets in California and Texas by signing definitive agreements to purchase five LTACHs in southern California for $180 million and three Texas-based nursing and rehabilitation centers for $38 million in two separate all-cash deals for a total purchase price of $218 million. Both transactions require regulatory approvals and are expected to close later this year. Read More...