SCOTUS Chevron Decision a Win for Healthcare

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

Altarum Report: Healthcare Spending Accelerates Between May 23 and May 24

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

The Economy and CCRC Performance – Update

Recently (June 12), the Federal Reserve held its latest FOMC (Federal Open Markets Committee) meeting and decided to maintain the current Fed Funds rate within the range of 5.25% to 5.50%.  The reasoning remains the current position of the economy, inflation therein, signals that inflation is a bit more persistent, and that without more definitive … Read more

Hospice Fraud and Abuse Front and Center

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

The Ensign Group Inc. Case Study: Nursing Home Chains Analysis

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

DOJ Gets Aggressive in Pursuit of Telehealth Fraud

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

Private Equity Investment in Nursing Home Sector Generates Regulatory Scrutiny

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

Preventing Falls in Seniors: Key Interventions Revealed by JAMA Study

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

FTC Bans Employment Non-Compete Provisions – Healthcare Implications Aplenty

On Tuesday, the Federal Trade Commission issued a final rule effectively, banning non-compete agreements, provisions, etc. for employees, including executives. The final rule contains separate provisions defining unfair methods of competition for the two subcategories of workers. Specifically, the final rule provides that, with respect to a worker other than a senior executive, it is … Read more

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