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Gregory Smith is a partner in the Governmental Practice in the firm's New York office.

On October 21, 2022, the Centers for Medicare and Medicaid Services (CMS) announced changes to its Special Focus Facility (SFF) program, including new steps to address nursing home facilities that fail to graduate from the SFF program in a timely manner, or “yo-yo” back into non-compliance after graduating from the SFF program. These changes are consistent with the Federal government’s goal of improving safety and quality of care for the nation’s roughly 1.5 million nursing home residents.

Continue Reading Long Term Care Update: CMS Revises Criteria for its Special Focus Facility Initiative

On September 21, 2022, the Select Subcommittee on the Coronavirus Crisis held public hearings and issued a report assessing the performance of large, for-profit nursing home chains during the early phase of the Coronavirus pandemic. The Subcommittee’s ongoing investigation began in June 2020, and focused on five for-profit nursing home chains that collectively operated over 850 skilled nursing facilities, each of which had significant outbreaks across their facilities. The Subcommittee’s key findings paint an extremely negative picture of for-profit facilities, and include the following allegations:

Continue Reading U.S. Congressional Committee Takes Aim at For-Profit Nursing Homes

In response to the COVID-19 Public Health Emergency (the “PHE”), the Centers for Medicare and Medicaid Services (“CMS”) issued numerous “blanket waivers” to increase access to medical services, and ease the regulatory burden on providers across the health care industry. In order to help providers understand the current status of the various waivers – some of which have been codified into law or adopted through the regulatory process, and others of which have already been terminated – CMS has issued a “Road Map” through a series of Fact Sheets for different provider types.

Continue Reading CMS Issues a “Roadmap” for the End of the COVID-19 Public Health Emergency and Blanket Waivers

The Biden Administration has expressed a deep concern about nursing home owners and related parties excessively profiting off of the residents they serve to the detriment of quality care. To address this concern, President Biden has asked Congress to implement laws that will empower federal agencies such as the Centers for Medicare and Medicaid Services (CMS) to increase accountability for facility ownership and expand enforcement authority at the ownership level. In addition, the federal agencies that regulate and oversee nursing homes (and some states[1]) have or plan to take action to ensure more transparency, compliance and enforcement regarding nursing facility ownership. Indeed, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) announced last week that it will undertake an audit of skilled nursing facility Medicare payments to related parties. Facility owners and operators should heed these developments, which as discussed below, focus on several fronts, and ensure that their relationships and operations are in accord with existing federal and state related party laws and regulations.

Continue Reading Nursing Homes Beware: the Government has Increased Its Scrutiny of Related Parties

On July 20, 2022, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued a Special Fraud Alert warning physicians and other practitioners to exercise caution when entering into telemedicine arrangements that have certain suspect characteristics.

Continue Reading OIG Warns Physicians About Entering into Arrangements with Telemedicine Companies