Supreme Court

Litigation Breaks on CMS Staffing Mandate

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As anticipated, litigation has started via various sources, in Federal courts, challenging CMS’ SNF “staffing mandate”. For specifics on the mandate and actual text, go here: https://rhislop3.com/2024/04/23/cms-final-snf-staffing-rule/ A big impetus behind the legal challenges to CMS mandate is the recent Supreme Court ruling known as the Chevron decision https://rhislop3.com/2024/07/01/scotus-chevron-decision-a-win-for-healthcare/ The decision overturns a longstanding doctrine … Read more

SCOTUS Chevron Decision a Win for Healthcare

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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

Compliance Update: Fraud and Abuse

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A complex area for providers, especially with respect to their compliance programs, are the concepts of fraud and abuse. Central to current requirements for compliance programs, all post-acute providers are REQUIRED to have compliance programs that, Include policies and procedures to define, test for, and mitigate any issues pertaining to fraud and abuse. In this … Read more

Friday Feature: 2 Court Cases

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As I close the week, I’ve been following a lot of legal news, specifically court cases involving health care and in one case, a decision from the Supreme Court. Legal news can be rather arcane and boring but, in some cases, the implications of decisions can be rather profound. Such is the case (no pun … Read more

Supreme Court Decides: Nursing Home Residents/Families Can Sue Public Facilities

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This morning, the Supreme Court ruled that residents and their surviving heirs/family members can sue a publicly owned nursing home under the Federal Nursing Home Reform Act. The court upheld a lower court ruling against the Health and Hospital Corporation of Marion County (HHC). This organization operates publicly owned (governmental) SNFs in Indiana. A couple … Read more

Friday Feature: The Supreme Court and Medicaid Beneficiary Rights to Sue

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TGIF! In a little known but important case argued in November of 2022, the family of a Medicaid nursing home resident in Indiana began a suit against a publicly owned nursing home (originally 2016), Valparaiso Care and Rehabilitation. The nursing home is operated by the Health and Hospital Corp. of Marion County. The corporation’s board … Read more

The Supreme Court, False Claims Act, and Implications for Providers

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Nearing the end of the Supreme Court session, the Court issued an important clarification ruling concerning the False Claims Act in cases of alleged fraud.  In the Universal Health Services case, the Court addressed the issue of whether a claim could be determined as fraudulent if the underlying cause for fraud was a lack of professional certification … Read more