Healthcare, Senior Living, Economics
Late June, the Department of Justice released its 2024 Healthcare Fraud Enforcement Action, detailing actions against nearly two hundred individuals, encompassing Medicare fraud totaling $2.75 billion in recovered losses ($1.6 billion in actual cash losses). One of the major problems with Medicare, aside from its structural financing, is that it is bureaucratically bloated, full of … Read more
Last week, the Supreme Court discarded a longstanding doctrine that granted regulatory agencies, such as the Centers for Medicare & Medicaid Services, extensive leeway to establish regulations for the organizations under their jurisdiction. The decision (majority opinion) in the case of Loper Bright Enterprises v. Raimondo is available here: SCOTUS Chevron Ruling The decision overturns a … Read more
From May 2023 to May 2024, the overall healthcare costs accelerated (increased) by 3.4%, marking the most rapid increase since December 2007, as reported in Altarum’s monthly Health Sector Economic Indicators brief, released yesterday. The report is available here: Altarum-June-2024-HSEI-Combined Expenditures on nursing home care increased by 4.8% year-over-year, while home healthcare spending saw a … Read more
Since I started this site, a topical area that has been a constant for me is hospice and in particular, fraud and abuse. Recent cases have again put Hospice fraud and abuse, front and center. Thematically, the cases are different and the same in so much that they involve improper billing of hospice cases to … Read more
In the midst of the Covid-19 pandemic, nursing homes across the United States faced daunting challenges. One such example is The Ensign Group Inc., the second largest for-profit chain in the country. A descriptive case study delves into the financial and quality metrics of this publicly traded U.S. nursing home chain during the age of … Read more
It was only a matter of time before cases involving telehealth fraud/False Claims Act cases became public. This week, two press releases from the DOJ illustrated how aggressive the agency has become in the pursuit of telehealth related fraud. I suspect more, larger in implication (dollar value, geographic spread), will drop publicly in the next … Read more
Arizona’s Attorney General, Kris Mayes, is challenging a major nursing home operator in the state with a new legal initiative aimed at ending the concealment of elder abuse and neglect. In March 2022, a resident with dementia was found face-down at Sun West Choice Health and Rehab. He had a massive bedsore − a telltale … Read more
My firm has a unique practice concentration in the area of complex litigation. Our expertise is principally on the defense side of claims. Our team assists long-term care providers in leveraging intricate data to safeguard against legal disputes and adverse public opinion. We help clients discover methods to analyze and utilize data from government, consumers, … Read more
Earlier this week, JAMA (Journal of American Medical Association) published a summary article on interventions to prevent/reduce falls in community-based (non-institutionalized) seniors. The core focus of the article is about preventing falls in seniors. The article is available here: jama fall prevention in older adullts As regular readers know, I don’t write a great deal … Read more
Happy Hump Day! Reg’s Blog is back up and running! Lots of stuff has happened over the past couple of weeks that the site was under construction or should I say, remodeling. I’ll try to get caught up on the important stuff and ultimately, get current as new events, etc. happen. Yesterday, an interesting lawsuit dropped … Read more