Healthcare, Senior Living, Economics
The Department of Justice (DOJ) announced that the agency recovered $2.9 billion in resolutions to federal False Claims Act allegations for 2024 (fiscal year ending September 30). This is a slight increase from the historic $2.7 billion recovered in fiscal year 2023. Office of Public Affairs | False Claims Act Settlements and Judgments Exceed $2.9B … Read more
On November 1 the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year 2025 Home Health Prospective Payment System (HH PPS) final rule, which updates Medicare payment policies and rates for Home Health Agencies. Unlike other Medicare provider types that have PPS rule updates corresponding to the federal fiscal year (10/1), home health … Read more
On September 30, US District Judge Kathryn Kimball Mizelle from the Middle District of Florida ruled in a landmark decision that the qui tam provision of the federal False Claims Act (FCA) is unconstitutional. This ruling could have significant impact on whistleblower (Qui Tam) actions filed against healthcare providers, particularly home health and hospice (most … Read more
The Accreditation Commission for Health Care, Inc. (ACHC) has launched two new specialty credentials for organizations providing home care and/or hospice. These programs are in line with the Age-Friendly Health Systems (Care) programs and initiatives started by The John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI), in partnership with the American Hospital Association (AHA) and … Read more
The mandatory Transforming Episode Accountability Model (TEAM) will advance CMS prior work on value-based care models, including bundled care initiatives. The TEAM model (participation) will be mandatory for selected hospitals and participation “optional” for post-acute care providers. Transforming Episode Accountability Model (TEAM) | CMS The Transforming Episode Accountability Model (TEAM) is set to be a … Read more
Mergers and acquisitions activity in the seniors housing and care sector set a new quarterly record with 183 publicly announced transactions in the second quarter of 2024, as reported by LevinPro LTC. This represents a 21% increase over the 151 transactions from the first quarter of 2024, and a 49% rise compared to the 123 … Read more
Private equity investment in the nursing home and assisted living sector (other post-acute as well) continues to be a focus of regulatory activity in Congress. This is despite private equity investment in the nursing home sector to be involve about 5% of facilities. Home health has seen an increasing investment interest as well from private … Read more
TGIF! A frequent reader sent me a note earlier in the week and asked if I would drop in more clinically oriented stuff from time to time. I asked for details, and she said stuff “that is germane to patient care and operational improvements – QA/QI stuff”. So, today’s post is by request, sort of. … Read more
Yesterday, the American Health Care Association and the National Center for Assisted Living plus the National Assocation of ACOs released a white paper that includes a set of recommendations for CMS, designed to increase the participation of long term and post-acute care (LTPAC) providers in accountable care organizations (ACOs). The white paper is available here: AHCA … Read more
This morning, the Department of Labor issued a final rule interpreting who is and who is not, an independent contractor v. an employee. Contract work in health care has boomed since the pandemic, though even pre-pandemic, the use of contractors (physicians, nurses, therapists, etc.) was on the increase. The final rule is available here: 2024-00067 The … Read more