Medicare Compliance & Reimbursement
HOSPITAL PREVAILS IN DECADE-OLD EMTALA CASE
A ten-year-old patient anti-dumping case that worked its way all the way up to the U.S. Supreme Court and back may finally be coming to an end - with the hospital in the case scoring a victory. The 6th U.S. Circuit Court of Appeals April 9 shot down the plaintiff's appeal of a jury verdict in Roberts v. Galen of Virginia Inc. (No. 93-00544). The case centered on care provided to Wanda Johnson, who was rushed to a Galen of Virginia hospital after being hit by a truck. Two months later, she was transferred to a skilled nursing facility, after which her health deteriorated. Johnson's guardian then sued Galen under the Emergency Medical Treatment and Active Labor Act. The case ended up producing an important Supreme Court ruling - establishing that plaintiffs don't have to prove that a hospital has an "improper motive" for transferring a patient to maintain an EMTALA claim - before finally being tried. The hospital won, both in the trial court and, thanks to the 6th Circuit's ruling, on appeal. To see the 6th Circuit's ruling, go to http://pacer.ca6.uscourts.gov/cgi-bin/getopn.pl?OPINION=03a0107p.06. Lesson Learned: Hospitals can face protracted EMTALA litigation even when there's no ill intent in transferring a patient.
Medicare Compliance & Reimbursement
- Outcomes:
HHAs USE HHQI TO SPREAD GOOD WORD ON HOME CARE
More than 1,200 home health agencies in eight states now have eleven patient outcomes posted [...] - Hospitals:
4 ORGAN ACQUISITION COST REPORTING PITFALLS
The complexities of Medicare reimbursement for organ transplant centers are all too clear in a [...] - HIPAA:
5 HIPAA COMPLIANCE PRESSURE POINTS
The much-anticipated compliance deadline for the Health Insurance Portability and Accountability Act privacy rule has [...] - Long-Term Care:
NURSING HOMES CAN'T STUMBLE ON DELEGATION COMPLICATIONS
Nursing home surveyors may soon be taking a closer look at the delegation of certain [...] - Managed Care:
THE DEVIL IS IN THE DETAILS WITH INSTITUTIONALIZED STATUS
Keeping up with the institutionalized status of Medicare beneficiaries enrolled in Medicare+ Choice plans has [...] - EMTALA:
HOSPITAL PREVAILS IN DECADE-OLD EMTALA CASE
A ten-year-old patient anti-dumping case that worked its way all the way up to the [...] - Settlements:
COMPUTER GLITCHES CAN COST YOU BIG
You don't have to profit from a billing snafu to have the feds come after [...] - Reimbursement:
HHAs WIN BREATHING ROOM ON PEPS
Home health agencies have received another reprieve from the recoupments of tens of thousands of [...] - OASIS:
SENATOR OPPOSES OASIS SUSPENSION FOR PRIVATE PAY
Home health agencies will continue to collect Outcome Assessment and Information Set data on their [...] - Therapy:
DOC-FURNISHED THERAPY NOT HHAS' RESPONSIBILITY
Starting this fall, physicians won't be knocking on home health agencies' doors asking for therapy [...] - Rehab:
REHAB HOSPITALS IN LINE FOR 3.3 PERCENT INCREASE
Inpatient rehabilitation hospitals would get a 3.3 percent reimbursement increase under a proposed rule to [...] - Whistleblowers:
WHISTLEBLOWER CFO TARGETS ALLEGED E&M SNAFUS
Here's one more reason to be sure your evaluation and management coding practices are up [...] - SNFs:
CMS PROPOSES SNF PAYMENT INCREASE
The Centers for Medicare & Medicaid Services will propose increasing payments to skilled nursing facilities [...] - HCA Watch:
DOJ APPROVES HCA SETTLEMENT
Nashville, TN-based HCA hospital giant came a step closer to putting an epochal fraud and [...] - PEOPLE
Centers for Medicare & Medicaid Services analyst Sean Tunis, MD, has been appointed the agency's [...] - PROGRAM MEMO ROUNDUP
Brace yourself, rehab providers. The Centers for Medicare & Medicaid Services is gearing up to [...]
