Tag: Senate
-
Iowa Lawsuit = More Bad News for Assisted Living
In January of 2022, a resident with dementia wandered out of her Assisted Living Memory Care facility in Iowa and ultimately, froze to death. The State of Iowa investigation uncovered that the resident wandered outside of the building at 9:30 p.m. the previous night. Her absence went unnoticed for eight hours plus even though the alarm…
-
Humana, United Health: Class Action Suits over AI use in Coverage Determination
It was only a matter of time before litigation came forward regarding the use of Artificial Intelligence (AI) in primarily, Medicare Advantage plans, where coverage denials/determinations are at issue. This week, a class action suit dropped in the U.S. Circuit Court of Western Kentucky against Humana. A link to the suit is here: https://www.scribd.com/document/692182281/Humana-AI-NaviHealth-MA-lawsuit In…
-
Senators Seek Survey Accountability for SNFs
Last Thursday, Senators Bob Casey (Pennsylvania), Ron Wyden (Oregon), and Chucky Grassley (Iowa) sent a letter to CMS asking that the agency “take immediate steps to strengthen the nursing home oversight system”. Their letter is a follow-up to a report from the Senate Committee on Aging, chaired by Casey, detailing a myriad of problems with…
-
Elections Have Consequences
Heading into round 2 of a three round debate format (tonight), I think its time to put a few core concepts on paper (or e-media in this case) for folks to remember about this political season. My role or task here is not to be partisan (your decision suffices on this front) but to be…
-
Senate Back and Forth on Psychoactive Medication Regs
Last week, Senators Kohl, Grassley and Blumenthal introduced an amendment to an existing FDA bill that would require the informed consent of nursing home patients or their legal surrogates before certain anti-psychotic/psychoactive medications were given. The target of this legislative initiative is to reduce the use of certain types of drugs commonly used to treat serious, chronic…
-
The Unraveling of the PPACA
OK readers and requesters, I haven’t gone, as Robert Frost wrote, into the “woods lovely, dark and deep” but I have been preoccupied by work and things familial. Sadly, energy wanes as one focuses intently on the delicate balance that is juggling a frenetic work schedule, a mile of other professional commitments, travel, and family. …
-
RUGs IV Here to Stay!
The news we all hoped for came forth this afternoon, wrapped with a big bow just in time for the Holiday season – RUGs IV is here to stay. The House this afternoon passed a companion version of the bill passed in the Senate yesterday. President Obama is expected to sign the bill into law…
-
Enhanced FMAP Funding Moving Through the Senate
On December 31st of this year, enhancements made to the Medicaid FMAP (Federal matching dollars) via the ARRA (Stimulus or American Recovery and Reinvestment Act) are set to evaporate. In a series of bills and other legislative initiatives throughout the spring and early summer, Congress has failed to extend funding to prevent the evaporation of…
-
Doc Fix Survives, Medicaid Ehanced Match Doesn’t
In another procedural vote on the revamped Jobs bill in the Senate, Democrats fell short of mustering 60 votes to end a Republican filibuster, effectively ending for now, legislative efforts to extend unemployment benefits. The vote count was 57 to 41 to continue debate. Dying with the extension of unemployment benefits are a series of…
-
Senate Doubles Back on “Doc Fix” Legislation
After a mid-week roadblock was established on a procedural vote all but derailing the American Jobs and Closing Tax Loopholes Act and the integrated provisions that included a “doc fix”, the Senate doubled-back on Friday and passed a separate measure that patches the pending cuts (21%) in the physician fee schedule set for June 1. …