December 2017 NLRB Changes Direction

Please click here to learn more about the December 2017 NLRB Memorandum and recent changes.

Posted in Regulatory | Tagged , , ,

Uncertainty is Creating Fear, and Private Equity Claims to be the Savior

The following article, written by Heather S. Miller, was published by the Palm Beach County Medical Society.

The Affordable Care Act (ACA) and passage of the Medicare Access and CHIP Reauthorization Act (MACRA) and its primary vehicle, the Merit-Based Incentive System (MIPS), have been transformative influences in the health care sector. Despite attempts to repeal and replace the ACA, the sentiment underlying MACRA – the transition from volume to value-based payments – is here to stay. Many small practices seem reluctant to take MACRA seriously, despite the fact that it puts yet another significant percentage of a provider’s Medicare reimbursements at risk. Large practices, understanding the uncertainties of complex payment reforms requiring advanced technology and business savviness to remain competitive, are responding by merging with other groups, joining hospital systems, or selling their practices to private equity investors. This niche is well-suited for private equity firms, as they feed on uncertainty.

Please click here to continue reading on Page 20 of the Palm Beach County Medical Society’s “On Call” Newsletter.

Posted in Heather Miller | Tagged , , , , ,

Taking Florida into the Future with Telemedicine

The following article, written by Kristina G. Maranges, was published by the Florida Bar Health Law Section Winter 2017 Newsletter.

On October 31, 2017, the Telehealth Advisory Council issued its recommendations to Florida Governor, Rick Scott, and the Florida Legislature on how to increase the use and accessibility of services provided via telehealth. The report comes on the heels of a state and national shortage of healthcare practitioners to serve our country’s growing and aging population. Echoing HHS’s designation of telehealth as a means or method  of delivering healthcare, not a type of healthcare service, and noting Florida regulations include multiple definitions of “telemedicine” but no definition of “telehealth” and these terms are commonly used interchangeably, the Council recommended a definition of “telehealth” to replace all existing definitions. “Telehealth is defined as the mode of providing health care and public health services through synchronous and asynchronous information and communication technology by a Florida licensed health care practitioner, within the scope of his or her practice, who is located at a site other than the site where a recipient (patient or licensed health care practitioner) is located.”

Recognizing the lack of adequate insurance coverage and reimbursement for healthcare services as barriers to the delivery and growth of telehealth services, the Council next recommended the Florida legislature require both coverage and reimbursement parity, excluding Medicare plans. Specifically, insurance policies must provide coverage for health care services delivered via telehealth if coverage is available for the same service provided in-person without the imposition of any additional conditions for coverage of services by the insurer,, and payment rates must be the equivalent to rates for comparable in-person services. Regarding Medicaid, the Council recommended the Agency (1) modify its telehealth fee-for-service rule to include coverage of store-and-forward (transmission of recorded health history like X-rays and photos through a secure electronic communications system to a practitioner who uses the information to evaluate the case or render a service outside of a real-time or live interaction) and remote patient monitoring (personal health and medical data collection from an individual in one location via electronic communications technologies, which is transmitted to a provider in a different location for use in care and related support) modalities; and (2) develop a model that would allow Medicaid Managed Care plans to utilize telehealth in order to meet network adequacy.

Posted in Kristina Maranges, Technology | Tagged , , , , ,

Have you seen CMS’ 32 measures under consideration for value based programs in 2018?

Visit this link for information directly from the Centers for Medicare & Medicaid Services.

Posted in Regulatory | Tagged , , , , ,

Firm Client Tops Nation in Medicare Savings

Broad and Cassel client, Palm Beach Accountable Care Organization, tops the nation in Medicare savings, as detailed in the article below from the Palm Beach Post: 

A doctor group based in Palm Beach County leads the country in saving taxpayers money while meeting goals for keeping Medicare patients happy and healthy.

Palm Beach Accountable Care Organization based in Palm Springs saved taxpayers $62 million and was allowed to keep $30 million of that for 2016 because it earned high scores for patient health and satisfaction, according to federal officials. The group ranked No. 2 nationally in shared savings a year ago.

“We’re keeping our patients healthier and out of the hospital,” said board chairman Richard Weisberg. “The savings are good and we’re proud of those. Keeping patients healthy is most important.”

The group of 275 primary-care doctors and 175 specialists serves 69,000 Medicare patients from St. Lucie County to Miami-Dade County.

Please visit this page to continue reading. 

 

Posted in ACO | Tagged , , , , , , , , , , , , , ,

Predictive Analytics: New Frontiers in Hospital Pharmaceutical Inventory Management

The following article, written by Paul R. DeMuro, Ph.D. and Richard M. Klass, was published by South Florida Hospital News and Healthcare Report.

It’s 3:00 a.m. The administrator on duty gets a frantic call from the pharmacy. “We ran out of cytarabine! This means no treatment for our existing leukemia patients and turning away ten newly diagnosed with appointments tomorrow! My doctors are screaming at me!

Panic sets in. The administrator thinks: “What if we can’t get other hospitals to lend us a supply? Do I dare access the ‘gray market’? Can we compound the drug ourselves?”

A good inventory control model can reduce such frenzied situations and:

• Minimize total inventory costs, including holding (interest rate) and order placement expenses.
• Support just in time inventory levels – having supplies when you need them and stocking nothing else saves cash outlays, and optimizes storage space. Remember, over-stocking is just as bad as under-stocking.
• Ameliorate out-of-stock situations of the most critical drugs, particularly those with no substitute alternative.
• Minimize expired pharmaceutical waste. “U.S. hospitals and long-term care facilities annually flush approximately 250 million pounds of unused pharmaceuticals down the drain.” Mismanaged expiration dates is a big cost driver.

To continue reading, please click here.

Posted in Paul DeMuro, Technology | Tagged , , , , , ,

Assistance with Rules Requiring Emergency Power

Emergency rules requiring emergency power sufficient to maintain an ambient temperature of 80 degrees Fahrenheit or below for 96 hours in nursing homes and assisted living facilities have just been announced. All nursing homes and assisted living facilities MUST submit an emergency management plan by October 31, 2017, and fully comply by November 15, 2017, unless a variance is obtained.

A link to the emergency rule for nursing homes can be found here.

A link to the emergency rule for assisted living facilities can be found here.

What if your facility cannot timely comply?

Many nursing homes and assisted living facilities will not be able to comply with the emergency rule deadlines. If your facility cannot timely comply with the emergency rule or has questions, we can help.

Broad and Cassel LLP represents two major provider associations in connection with the emergency rulesWe can assist your facility with:

  • Variance Petition: If you are unable to implement the applicable emergency rule’s requirements by November 15, 2017, we can petition the appropriate agency on your behalf and request additional time to comply with the emergency rule.
  • Notifications of Compliance: If you are already in compliance or able to get into compliance by November 15, 2017, we can prepare and submit a notification of compliance on behalf of your facility.

For preparation of the variance or notification of compliance, our rates are $1,500 for engagements entered into prior to October 13th and $2,500 for all engagements entered between October 13th and 24th. All other legal services will be charged at the blended hourly rate of $250.00 per hour. Due to the large number of variances and notifications of compliance we anticipate preparing, Broad and Cassel will not give priority to emergency rule petition engagements after October 24, 2017.

Please visit this link for a client information package. 

For more information, contact Jay Adams, Esq. at 850-681-6810 or via email at jadams@broadandcassel.com.

Posted in Care Delivery, Compliance, David Miller, Douglas Mannheimer, Frank Rainer, Jay Adams, John Loar, Joshua Brian, Leonard Collins, Uncategorized | Tagged , , , , , , , , , , ,

Jamie Gelfman Joins Broad and Cassel’s Health Law Team

FORT LAUDERDALE (Sept. 28, 2017) – Statewide law firm Broad and Cassel LLP today announced the addition of Associate Jamie Gelfman to the firm’s Health Law Practice Group in the Fort Lauderdale office.

Prior to joining Broad and Cassel, Gelfman was an associate at Panza, Maurer & Maynard, P.A. where she primarily practiced in the arenas of administrative and regulatory law. While there, she advised clients on health care compliance issues; aided in the investigation, mitigation and reporting of HIPAA breaches; assisted with reimbursement issues and licensure issues with AHCA; and prepared HIPAA Privacy and Security Policies, Notices of Privacy Practices, HIPAA Authorizations for Use and Disclosure, Business Associate Agreements, and Informed Consents. To continue reading, please click here.

Posted in Practice News | Tagged , ,

Retired CEO Howard Root to Headline Broad and Cassel Health Forum Oct. 11

FORT LAUDERDALE, Fla. (Aug. 24, 2017) — Broad and Cassel’s Health Law Practice Group will once again host national and local experts for discussions around today’s rapidly changing health care landscape at the annual Broad and Cassel Health Forum Oct. 11.

New to the speaker lineup this year is retired CEO Howard Root, who after a five-year ordeal with the U.S. Department of Justice, authored Cardiac Arrest: Five Heart-Stopping Years as a CEO On the Feds’ Hit-List. A corporate lawyer by trade, he founded Vascular Solutions in 1997, and during his tenure, invented and launched more than 100 cardiovascular devices. Root will share his legal nightmare of how he fought Federal criminal charges that a jury summarily dismissed.

Also offering a keynote presentation is The Advisory Board Company on the playbook for population health followed by two panel discussions. Panel topics will cover compliance and risk, and medical transactions with private equity.

Panels will be moderated by Broad and Cassel Fort Lauderdale Managing Partner Gabriel Imperato and Partner Mike Segal, co-chair of the firm’s Health Law Practice Group. Additional Broad and Cassel attorneys joining the panels include Of Counsel Anne Branan and Senior Counsel O. Benton Curtis.

The Health Forum is sponsored by Broward County Medical Association, Dade County Medical Association, Palm Beach County Medical Society, ProAssurance Companies, PYA, South Florida Medical Group Management Association, South Florida Hospital and Healthcare Association, South Florida Hospital News, SunTrust and Withum.

What:

Seventh Annual Broad and Cassel Health Forum

The cost to attend is $90 and includes lunch and a cocktail reception following the presentations. To register, click here or contact Elizabeth Levine at elevine@broadandcassel.com or 407-839-4229.

When:

11 a.m.-6 p.m.   Wednesday, Oct. 11

11 a.m.             Registration and lunch

12 p.m.             Presentations begin

5 p.m.               Networking cocktail hour for participants, sponsors and speakers

Where:

Signature Grand, 6900 State Road 84, Davie, FL 33317

Broad and Cassel has built one of the most experienced and diversified Health Law Groups in the Southeastern United States. The firm has more lawyers certified in Health Law by the Florida Bar Board of Legal Specialization & Education than any other firm. Many of the firm’s health lawyers are certified by the Health Care Compliance Association in Health Care Compliance and are Certified Dispute Resolvers with the American Health Lawyers Association.

Information on the firm’s health law events and industry and attorney news can be found on Broad and Cassel’s Health Law Blog at http://www.healthlawfla.com or on Twitter at http://www.twitter.com/healthlawfla.

Posted in Health Forum | Tagged , , , ,

Medicare Fraud Strike Force Expands to Orlando

By: Mike Bittman

In July 2017, the Departments of Justice and Health and Human Services  opened a new Medicare Fraud Strike Force in Orlando, the third in Florida.

 

The original Medicare Fraud Strike Force opened in Miami in March 2007. Due to the success of the Miami Strike Force, and increased funding, DOJ and HHS opened Strike Forces in eight additional areas with high levels of billing fraud: Los Angeles, Detroit, Houston, Brooklyn, Baton Rouge, Tampa, Chicago, and Dallas. Since inception, the Medicare Fraud Task Forces have brought criminal charges against over 3,500 defendants who collectively falsely billed Medicare over $12.5 billion.

 

The Strike Force model consists of interagency teams made up of investigators and prosecutors that focus on the worst offenders engaged in fraud. The Strike Force uses  advanced data analysis techniques to identify suspicious billing levels, and targets schemes that migrate from one community to another. Members of the Orlando Strike Force include a prosecutor with the DOJ Criminal Division Fraud Section with Strike Force experience, prosecutors in the U.S. Attorney’s Office for the Middle District of Florida, FBI agents, HHS-OIG agents, and Florida law enforcement officials.

 

This expansion portends more federal criminal investigations and prosecutions in the Orlando area. Providers, suppliers, and contractors to Medicare, Medicaid, and TRICARE are well advised to increase their compliance efforts, including conducting thorough review and investigation of all reports of non-compliance. 

 

For more information on health care compliance, you may be interested in attending the 7th Annual Broad and Cassel Health Care Forum on October 11, 11:00 am – 6:00 pm, at the Signature Grand, 6900 State Road 84, Davie, FL 33317. You can register at this link:  http://events.r20.constantcontact.com/register/event?oeidk=a07ee5i4a0kc0991444&llr=gpww5cdab&showPage=true

 

Posted in Health Forum, Mike Bittman | Tagged , , , ,