Wednesday Feature: Massachusetts Nursing Home Residents Set to Transition to Community Living with $1 Billion Settlement

Happy Hump Day! Last week, the Lieutenant Governor of Massachusetts, Kim Driscoll, announced the settlement of a class action lawsuit filed against the state by six disabled nursing home residents. The suit was filed in 2022 alleging that the state underfunded community-based care options, trapping them in nursing homes despite their wishes to return to … Read more

Friday Feature: An End to Arbitration Clauses?

TGIF! It’s been a long week with the eclipse and lots of economic news plus all the stuff going on in the Middle East. My inbox is flooded so weekend reading will need to include a lot of parsing and pitching. On Tuesday in the Senate, a bill was introduced by Senators Blumenthal (CT) and … Read more

Recent HIPAA Right of Access Settlements Highlight Ongoing Enforcement Efforts

SNFs this one is for you! Yesterday’s post on billing fraud was too. It almost feels as if this second week of April has a compliance theme while last week, the focus was on CMS Proposed Rules. Assuredly, Wednesday will bring some different news as March CPI data drops. This news came last week via … Read more

Medicare, DOJ, Fraud and the Eclipse?

Happy Eclipse Monday! The post title is meant as a bit of fun but there is a bit of relevancy as well. Billing fraud occurs via a process of hiding what actually has transpired (or should have) with the care of a patient. The most typical fraud is overbilling or charging the government for care … Read more

Skilled Nursing Operator Takes Legal Action Against Staffing Platform for Alleged Overbilling

A little over a week ago, an SNF operator dropped a lawsuit in U.S. District Court in the District of Utah against a staffing platform that works somewhat, like a staffing agency. The platform Nursa acts as a software clearinghouse connecting nursing staff (RNs. LPNs, CNAs, etc.) to facilities with open shifts – “Nursa exists … Read more

Sign of the Times: Petersen Health Care Files for Bankruptcy

Mid last week, Petersen Health Care, a Peoria, IL based nursing home operator filed for bankruptcy in Delaware. SC Healthcare Holdings LLC, which operates as Petersen Health Care, in federal court filings last Wednesday said it is seeking Chapter 11 bankruptcy protection because of ongoing financial problems partly due to an October ransomware attack and … Read more

Record-breaking $2.7 Billion Paid by Healthcare Providers in False Claims Act Cases

A couple of weeks ago, on February 22nd. the Department of Justice issued its annual statement regarding False Claims Act activity in FY 2023 (federal fiscal years run 10/1 to 9/30). “Settlements and judgments under the False Claims Act exceeded $2.68 billion in the fiscal year ending Sept. 30, 2023. The government and whistleblowers were … Read more

Friday Feature: Legal Battle Unfolds Over Nursing Home Negligence Amid Pandemic Era

TGIF! Within a busy econ news week, a little litigation matter slipped into my news stream. These cases are fascinating as we continue to see the pandemic litigation trickle forward and the novelty of claims arising from the pandemic period/Public Health Emergency period beginning to define the litigation playing field. Readers/followers know by now that … Read more

Wednesday Feature: Navigating the Evolving Landscape – Enhancing Ethics and Compliance Programs for Risk Mitigation

Happy Hump Day! Long title for what is going to be, a rather brief post.  As followers and regular readers know, my firm (I am the co-founder and part owner) H2 Healthcare, LLC has a practice area uniquely concentrated on clinical compliance and complex litigation support.  The practice area is headed by Diane Hislop, RN (yes, … Read more

Unveiling the Allegations: Lawsuit Claims Advocate Aurora Health’s Monopoly on Health System is Hiking Prices in Wisconsin

Late last week, I ran across a number of news posts regarding a proposed class action lawsuit against the hospital/health system giant Advocate Aurora, alleging that the organization used its market mass to limit competition and in return, impose excessively high prices on commercial health plans and their insureds. The suit was filed in Wisconsin (where … Read more