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- Audience: Post-Acute and Long-Term Care
Alerts
OIG Allows Patient Assistance Programs Funded by Drug Manufacturers
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (24-02) permitting a non-profit organization (Non-Profit) to provide financial support to eligible patients with specific rare diseases through assistance programs (Programs) it operates.
Alerts
CMS Announces Payment Program for Providers Impacted by Change Healthcare Cyberattack
On March 9, 2024, CMS announced it will make available Change Healthcare/Optum Payment Disruption accelerated payments to providers experiencing potentially significant cash-flow problems as a result of the cyberattack on UnitedHealth Group’s subsidiary Change Healthcare/Optum .
Alerts
Nursing Home Alert: Dramatic Increase in NYS DOH Life Safety Code Citations
Nursing homes being cited for Life Safety Code (LSC) deficiencies by the New York State Department of Health (DOH) are on the rise. The difficulty achieving substantial compliance or obtaining a waiver places nursing homes at risk for termination from Medicare and Medicaid, denial of payments, and monetary penalties.
Alerts
OIG Issues New Resource for Single Audits
The United States Department of Health and Human Services (HHS), Office of Inspector General (OIG) recently posted a new educational resource on its website about Single Audits. HHS is the largest grant-making agency in the Federal government, and OIG’s new resource is designed to help key stakeholders understand the scope of Single Audits, as well as improve the overall quality of such audits.
Alerts
Governor Hochul Proposes Significant Changes to CDPAP and to LHCSA Enrollment in Medicaid
Governor Hochul’s 30-day Amendments to her proposed state fiscal year 2025 Executive Budget would significantly change New York State’s (NYS) Consumer Directed Personal Assistance Program (CDPAP) and what licensed home care services agencies (LHCSAs) can enroll or re-enroll in Medicaid.
Alerts
New York OMIG Updates Self-Disclosure Guidance
The New York State Office of the Medicaid Inspector General (OMIG) recently updated its Self-Disclosure Guidance and Frequently Asked Questions (collectively, “Updates”). These Updates give participating providers and entities additional insight into how to report overpayments involving unresponsive Medicaid Managed Care Organizations (MMCOs) or multiple entities, as well as those that are untimely, have adjusted or voided claims, or lost or damaged records.
Alerts
OIG Approves Creative Approach to Restructuring Medical Practice Partnerships
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (23-12) that allows a limited liability partnership (the Partnership) consisting of two classes of physician partners to make a one-time, voluntary redemption offer (offer) to individual partners when they reach age 67.
Alerts
OIG Approves Use of Gift Cards for Referrals in Certification-Heavy Advisory Opinion
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (23-15) permitting a consulting company’s (Consultant) proposal to offer gift cards to its current physician practice customers for referring potential new physician practice customers to Consultant. Notably, OIG determined that the proposed arrangement did not implicate the Anti-Kickback Statute (AKS).
Alerts
OIG Issues Toolkit for Medicare Advantage Organizations
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) released a new toolkit to help Medicare Advantage (MA) organizations replicate OIG audit methodologies to detect and correct inaccurate diagnosis codes in their own systems.
Alerts
OMIG’s 2024 Work Plan Gives Critical Insights into Program Integrity Initiatives
The New York State Office of the Medicaid Inspector General (OMIG) released its 2024 work plan in furtherance of its mission to coordinate and conduct activities to prevent, detect and investigate medical assistance program fraud, waste and abuse, and to recover improperly expended Medicaid funds.
Alerts
More Provider “Nuggets” From OIG’s Year-End Reporting Blitz
Continuing its year-end reporting blitz, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its Semiannual Report (SAR) to Congress on December 1, 2023.
Alerts
OIG’s Favorable Advisory Opinions Allow Incentives to Medigap Plan Policyholders
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted two favorable Advisory Opinions (23-09 and 23-10) to allow a licensed offeror of Medicare Supplemental Health Insurance (Medigap Plan) policies and a preferred health organization (PHO) (collectively, “the requestors”) to incentivize Medigap Plan policyholders to seek inpatient care from a hospital within the PHO’s network. Notably, OIG issued these favorable opinions even though the proposed incentives implicated the Anti-Kickback Statute (AKS) and the Beneficiary Inducement Civil Money Penalty (CMP), and there was no applicable exception or safe harbor.
Alerts
New CMS Disclosure Requirements for Nursing Homes
On November 17, 2023, the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) published a final rule (“Final Rule”) imposing new ownership disclosure requirements on Medicare skilled nursing facilities and Medicaid nursing facilities (“nursing homes”). Due to concerns over the quality of patient care in facilities owned by certain types of nursing facility owners, including private equity companies and real estate investment trusts, CMS believes these new disclosure requirements will allow them to monitor and hold nursing homes accountable.
Alerts
DOJ/HHS Jointly Release "Highlight Reel" Report
This week, the United States Department of Justice (DOJ) and the United States Department of Health and Human Services (HHS) fulfilled its annual statutory obligation by releasing its jointly-authored Health Care Fraud and Abuse Control Program (HCFAC) Report for Fiscal Year 2022.
Alerts
OIG Provides Roadmap to Hot-Button Issues
The OIG fulfilled its annual statutory obligation by releasing its Top Management and Performance Challenges (TMC) document. Providers should take note because the document provides important insight into the specific areas over which HHS (and the OIG) will remain focused.
Alerts
New York DOH Adopts New Requirements for All Adult Care Facilities
On November 15, 2023, the DOH adopted new regulatory requirements for adult ACFs in an effort to expand resident rights in conformance with the CMS’s HCBS rule final rule. ACFs across the State are now required to allow residents to have visitors at any time, giving them unrestricted access to common areas.
Alerts
OIG Releases New General Compliance Program Reference Guide
On November 6, 2023, the OIG released its General Compliance Program Guidance, the first in a series of new, non-binding reference guides designed to share information with health care compliance professionals and other health care industry stakeholders
Alerts
Temporary Health Care Staffing Agencies Now Required to Register in New York
In what appears to follow a multi-state trend to protect “temporary” workers, as part of the New York Budget for FY 2023-2024, a new law went into effect that requires any entity that provides temporary staff to health care entities to register with the Department of Health (DOH).
Alerts
Payment Error Rate Measurement Program for Florida Medicaid and Chip Providers
On February 17, 2023, Florida Medicaid released a Health Care Alert reminding providers of their obligations under the Centers for Medicare and Medicaid Services (“CMS”) Payment Error Rate Measurement (“PERM”) program.
Events
Garfunkel Wild and Garfunkel Health Advisors Complimentary Webinar – Major Changes to E/M Coding and Documentation Requirements in 2023 – Will You Be Ready?
Garfunkel Health Advisors Alicia Shickle, Simon Chaykler, and Garfunkel Wild’s Robert A. Del Giorno will present the webinar ”Major Changes to E/M Coding and Documentation Requirements in 2023 – Will You Be Ready? on November 8 and 9, 2022.
Events
Health Care Hot Topics: Florida’s New Minimum Wage Requirements For Medicaid Providers
Garfunkel Wild's Susan St. John discusses the things providers need to know about the new minimum wage requirements, and a new civil cause of action for non-compliance.
Events
Garfunkel Wild Webinar – Handling COVID-19 Employee Vaccinations, Updated Leave Entitlements & Addressing Violations of COVID-19 Protocols
Garfunkel Wild’s Marianne Monroy, Salvatore Puccio, and Lauren Levine will present the webinar “Handling COVID-19 Employee Vaccinations, Updated Leave Entitlements & Addressing Violations of COVID-19 Protocols” on January 26, 2021.
Events
New York State Society of Orthopaedic Surgeons Virtual Annual Meeting and Symposium
Barry Cepelewicz will present at the New York State Society Of Orthopaedic Surgeons Virtual Annual Meeting and Symposium – November 7, 2020.
Events
72nd Annual Health Care Association of New Jersey Convention – Virtual
Jeffrey Brown and Robert Del Giorno will present at the 72nd Annual Health Care Association of New Jersey Convention – Virtual – on October 27, 2020.
Events
Garfunkel Wild Webinar – Returning to Work in the COVID-Era: Employee Issues, What to Expect and How to Prepare
Garfunkel Wild’s Andrew Zwerling, Marianne Monroy, Salvatore Puccio and Lauren Levine will present the webinar “Returning to Work in the COVID-Era: Employee Issues, What to Expect and How to Prepare” on June 12, 2020.
Events
Garfunkel Wild Webinar – Personal Advance Care Planning in a Pandemic: How can I get my health care proxy, living will, and estate planning documents in order?
Garfunkel Wild’s Eve Green Koopersmith and Doris L. Martin will present the webinar “Personal Advance Care Planning in a Pandemic: How can I get my health care proxy, living will and estate planning documents in order” on April 23, 2020.
Events
Garfunkel Wild Webinar – An Employer’s Practical Guide To Facing Day-To-Day Coronavirus Challenges
Garfunkel Wild’s Andrew Zwerling, Marianne Monroy, Salvatore Puccio, and Lauren Levine will present the webinar “An Employer’s Practical Guide To Facing Day-To-Day Coronavirus Challenges” on April 20, 2020.
Events
Garfunkel Wild Webinar – COVID-19 Billing for Telemedicine Services and Q&A Session
Garfunkel Wild Partner/Director Debra A. Silverman and Partner Stacey L. Gulick along with Certified Professional Coder and President of ProCode Compliance Solutions, LLC, Alicia Shickle will present the webinar “COVID-19 Billing for Telemedicine Services and Q&A Session” on March 25, 2020.
Events
2nd Annual Center for Health Education, Medicine, & Dentistry (CHEMED) Conference on Medicine & Ethics
Jeffry Adest will present at the 2nd Annual Center for Health Education, Medicine, & Dentistry (CHEMED) Conference on Medicine & Ethics on February 14, 2020.
Alerts
Mental Hygiene Legal Service to Represent New York Nursing Home Residents
The New York State Legislature has expanded the authority of Mental Hygiene Legal Service (“MHLS”) to provide legal assistance to certain residents of residential healthcare facilities.
Events
Nassau County Bar Association’s Hospital & Health Law Committee Meeting
Stacey L. Gulick will present at the Nassau County Bar Association’s Hospital & Health Law Committee Meeting on November 7, 2019.
Events
Monroe County Medical Society Webinar Survival: HIPAA Webinar
Stacey Gulick will present at Monroe County Medical Society Webinar Survival Series: HIPAA Webinar on September 26, 2019.
Events
Argentum Executive Director Leadership Institute (EDLI)
Eve Green Koopersmith will present at the Argentum Executive Director Leadership Institute (EDLI) on September 25, 2019.
Events
Fraud and Abuse – Lessons from Esformes Case
John Martin will present the “Fraud and Abuse – Lessons From Esformes Case” Webinar on September 18, 2019.
Events
Nassau County Bar Association (NCBA) Hospital and Health Law Committee CLE – Recent Trends in Health Care Fraud Investigations
John G. Martin and Robert A. Del Giorno will present at the Nassau County Bar Association’s CLE – Recent Trends in Health Care Fraud Investigations on September 17, 2019.
Events
LeadingAge New York Financial Professionals Annual Conference
Debra A. Silverman will present at the LeadingAge New York Financial Professionals Annual Conference on September 11, 2019.
Events
Community Health Care Services Foundation, Inc. (CHC) Webinar – Managed Long Term Care Managed Long Term Care Value Based Payment Contracting
Debra A. Silverman will present at the Community Health Care Services Foundation, Inc. Webinar – Managed Long Term Care on September 10, 2019.
Events
Andrew Blustein was selected as an instructor at The Horizon Foundation for webinar, “Do No Harm: Exploring Strategies for Safer Prescribing of Opioids”.
Andrew Blustein was selected as an instructor at the Horizon Foundation for Webinar, “Do No Harm: Exploring Strategies FOR Safer Prescribing Of Opioids.”
Events
Healthcare Financial Management Association (HFMA) 18th Annual Healthcare Conference
Debra A. Silverman will present at the Healthcare Financial Management Association’s (HFMA) 18th Annual Healthcare Conference on May 22, 2019.
Events
Fairfield County Medical Association’s (FCMA) Webinar – Navigating Sexual Harassment in the Workplace for Managers and Supervisors
Marianne Monroy and Salvatore Puccio will present at the FCMA’s Webinar – Navigating Sexual Harassment in the Workplace for Managers & Supervisors on May 9, 2019.
Alerts
New MOLST Forms and Checklists Published by DOH
The New York State Department of Health has made changes to the Medical Orders for Life Sustaining Treatment (MOLST) form and Nonhospital Order Not to Resuscitate, DOH Forms 5003 and 3474, respectively. These changes were made to comply with statutory changes, which granted authority to Nurse Practitioners to sign the MOLST and Nonhospital Order Not to Resuscitate.
Events
Hudson Valley Annual Institute 2019
Andrew l. Zwerling, Marianne Monroy and Salvatore Puccio will present at the Hudson Valley Annual Institute on April 4, 2019.
Events
BKD CPAs & Advisors’ Webinar – Preparation for Your HRSA Operational Site Visit
Jeffry Adest will present at the BKD CPAs & Advisors’ Webinar – Preparation for your HRSA Operational Site Visit on March 19, 2019.
Events
Garfunkel Wild Webinar – Home Care Referrals, Marketing and the Kickback Laws
Garfunkel Wild Partner/Director Peter M. Hoffman will host a webinar entitled “Home Care Referrals, Marketing, and the Kickback Laws” on Tuesday, March 19, 2019.