Expiration of the Long Term Care Hospital Development Moratorium: A Lasting Development Opportunity?

Posted by Jason Greis on January 5, 2013 under Articles | Be the First to Comment

Under the Medicare, Medicaid and SCHIP Extension Act of 2007 (the Act), as amended, Congress imposed an initial three-year moratorium on the establishment of new Long Term Care Hospitals (LTCH), on LTCH satellite facilities and on increases in the number of beds in existing LTCH facilities, unless an exception to the moratorium applied. This moratorium was subsequently extended for two years by the Patient Protection and Affordable Care Act (ACA).  The Centers for Medicare and Medicaid Services (CMS) recently announced, in its Final Rule updating fiscal year (FY) 2013 Medicare payment policies and rates for inpatient stays at general acute care hospitals and LTCHs that the LTCH development moratorium would expire as of Decem ber 29, 2012.  The moratorium has since sunsetted. Read More...

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

Posted by Jason Greis on March 2, 2011 under Articles | Be the First to Comment

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...

Health Reform: Is the Hospital Industry Misapplying Congressional Intent?

Posted by Jason Greis on October 13, 2010 under Articles | Be the First to Comment

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

Posted by Jason Greis on October 12, 2010 under Articles | Comments are off for this article

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...

Complimentary McGuireWoods Webinar: The Impact of Healthcare Reform on Hospital Consolidation

Posted by Jason Greis on August 24, 2010 under Events | Be the First to Comment

Thursday, September 16, 2010
Noon – 1 p.m. (ET) | 11 a.m. – Noon (CT) | 9 a.m. – 10 a.m. (PT)
Complimentary Webinar
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CMS Issues Proposed Rule on Changes to Stark In-Office Ancillary Services Exception

Posted by Jason Greis on August 12, 2010 under Articles | Be the First to Comment

Section 6003 of the Patient Protection and Affordable Care Act, Public Law 111-148 (H.R. 3590) (PPACA) makes a change to the “in-office ancillary services” exception to the Stark physician self-referral law that impacts physician practices providing certain radiology services in their offices. In short, the change requires physicians making a referral for magnetic resonance imaging (MRI), positron emission tomography (PET), and computed tomography (CT), or certain other radiology services in their offices, to make a disclosure to the patient that such services can be provided elsewhere and to include a list of alternative providers. Read More...