Nursing
Homes
Since its inception in 1980, Miles & Peters has maintained a pro active
approach to resolving legal issues affecting nursing homes. Nursing homes
face unique challenges: a myriad of government regulations at both the state
and federal level, including the Medicare/Medicaid requirements of participation,
significant rate and reimbursement concerns as to government funding; constant
compliance questions over fraud and abuse directives; and now, but not least,
new and complex confidentiality regulations under HIPAA. The firm also provides
consultation and representation in such diverse areas as corporate, contractual
and program compliance matters as well as defending medical malpractice claims.
We provide the latest analysis of all matters affecting this regulatory environment
and are on top of late breaking developments at both the national and state
level. Attorneys representing this practice group have over 80 years of combined
advocacy experience representing nursing homes in administrative appeals, regulatory
hearings and civil litigation. This experience also includes providing legal
assistance to the state's largest nursing home trade organization on its governmental
affairs program.
Click for News and Information regarding:
PENNSYLVANIA NURSING
HOME FACILITY SETTLES WITH U.S. GOVERNMENT
A Philadelphia nursing home agreed to pay the
federal government $50,000.00 in a civil settlement for inadequate treatment
and prevention of pressure wounds and falls, according to the U.S. Attorney
for Eastern District of Pennsylvania.
Pointing to the False Claims Act (see§1138), the government alleged
that the nursing home billed Medicare and Medicaid for inadequate services
between July 2002 and June 2003. The nursing home denied the accusations,
but agreed to the settlement to avoid litigation.
A copy of the settlement is available HERE.
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GUIDANCE SPELLS OUT RESPONSIBILITIES
IN IDR PROCESS
While federal requirements give states flexibility in how
they grant skilled nursing facilities and long-term care providers the opportunity
to contest survey deficiencies cited on Form 2567, recent guidance reminded
state survey and certification agencies that such programs must be consistent
with federal regulations and provisions outlined in the State Operations
Manual.
A copy of the memo is available online at http://www.cms.hhs.gov/medicaid/survey-cert/sc0510.pdf.
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DOJ
OFFERS GUIDANCE ON NONDISCRIMINATION AGAINST
LIMITED ENGLISH SPEAKERS
The Civil Rights Division of the U.S. Department of Justice issued guidance
October 26 on what recipients of federal assistance-including hospitals-must
do to ensure they are not discriminating against those with limited English
proficiency.
The guidance is online at www.usdoj.gov/crt/cor/lep/Oct26Memorandum.htm.
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CMS PUBLISHES NATIONAL PROVIDER
IDENTIFIER FINAL RULE
On January 23, 2004 CMS published the long awaited National Provider Identifier
(NPT) final rule. This NPT final rule requires all health care organizations
to use an assigned identifier for each health care provider when filing and
processing electronic claims and other standard transactions.
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