Millions at Risk to Lose Medicaid Coverage as of April 1, 2023

Analysts estimate that up to 18 million people (or one in five enrollees) will lose Medicaid coverage between this year and next, and among those, 3.8 million will remain without health insurance. Here is what you need to know. Medicaid enrollment ballooned by 20 million people during the Covid-19 pandemic to nearly 84 million people. That was no fluke: with a declaration of a Public Health Emergency (PHE), states were barred from removing people from the program. This is all about to change. The $1.7 trillion government spending bill passed in December reinstated states’ ability to kick people off Medicaid, [...]

2024-03-08T11:12:02-05:00January 20, 2023|

CMS to Make More Medicare Nursing Home Ownership Data Publicly Available

Additional Medicare nursing home ownership data is being made publicly available by the U.S. Department of Health and Human Services (HHS) through the Centers for Medicare & Medicaid Services (CMS). This effort may help improve nursing home transparency, safety and quality, and accountability by providing more information about the ownership of all Medicare-certified nursing homes. This data will, for the first time, give state licensing officials, state and federal law enforcement, researchers, and the public an enhanced ability to identify common owners of nursing homes across nursing home locations. This information can be linked to other data sources to identify [...]

2024-03-08T11:21:40-05:00October 21, 2022|

CMS Updated Nursing Home Regulation Guidance

On June 29, 2022, the Centers for Medicare & Medicaid Services (CMS) released much-awaited Phase 3 guidance along with updated Phase 2 guidance on nursing home regulation. The guidance was issued as the result of 2016 revisions to the Medicare Requirements for Participation for Nursing Homes. Due to delays caused by the COVID-19 pandemic, CMS is only now releasing the last set of guidance for nursing home regulation, which was originally scheduled to be released in 2019. The Phase 3 guidance offers significant updates to the requirements state oversight agencies must follow when surveying and assessing a nursing home's compliance [...]

2024-03-08T11:27:18-05:00July 22, 2022|

Gallardo v. Marstiller: Supreme Court Decision’s Impact on Personal Injury Settlement

The Supreme Court recently ruled 7-2 in Gallardo v. Marstiller, Secretary of the Florida Agency for Health Care, that the federal Medicaid Act does not preempt Florida's policies dictating how the state can obtain Medicaid reimbursements from third parties and that Florida was, therefore, able to seek reimbursement from personal injury settlement payments. Background in the Gallardo v. Marstiller case, according to the syllabus: "Petitioner Gianinna Gallardo suffered catastrophic injuries resulting in permanent disability when a truck struck her as she stepped off her Florida school bus. Florida’s Medicaid agency paid $862,688.77 to cover Gallardo’s initial medical expenses, and the [...]

2024-03-08T11:28:34-05:00June 14, 2022|

Death with Dignity: New Jersey’s Medical Aid in Dying for the Terminally Ill Act

Oregon has ended its residency requirement for the state's physician-assisted suicide law, known as the Death with Dignity Act, as a result of a pending lawsuit challenging the constitutionality of its residency requirement. Previously, you must have been a citizen of Oregon in order to avail yourself of Oregon’s Death with Dignity Law. The lawsuit, filed in October 2022 on behalf of Dr. Nicholas Gideonse, a Portland, Oregon physician, contended that restricting the right to die by state lines violated Oregon's Death with Dignity Act and the U.S. Constitution. Gideonse was working with the nonprofit organization Compassion & Choices, which [...]

2024-03-08T11:30:44-05:00April 5, 2022|

The No Surprises Act: New Ban on Surprise Medical Bills

The No Surprises Act brings new protections for patients in out-of-network care. Read on below to learn more. You are taking that ski vacation in Jackson Hole, Wyoming that you have been planning for all year. Well, things did not go exactly as planned. You ended up in the ER in Jackson Hole after fracturing your ankle on the ski slope, requiring surgery. Thirty days later, back home, you receive a bill for thousands of dollars for the medical services received because the services were performed by an out-of-network provider. 2022 brings new protections in such a scenario. Patients with [...]

2024-03-08T12:11:09-05:00January 7, 2022|

Important Update on Nursing Home Visitation Guidance from CMS

On November 12, 2021, the Centers for Medicare & Medicaid Services (CMS) updated their Nursing Home Visitation Guidance. After over a year and a half of residents and their loved ones being separated from each other and subject to confusing and often ignored nursing home visitation guidance, visitation is now allowed at all times for all residents, including indoor visitations.  All visitors must continue to adhere to infection prevention practices. Additional key points of new guidance include: Facilities can no longer limit frequency and length of visits, number of visitors, or require advanced scheduling of visits. Vaccinated and unvaccinated residents [...]

2024-03-08T12:13:08-05:00November 18, 2021|

Build Back Better Act Items of Interest to Seniors

The details of the Biden administration’s scaled-back budget bill titled the “Build Back Better Act” are out after several months of negotiations among Democratic lawmakers. Although there is a great deal out of the bill, such as Medicare coverage for dental and vision, the good news for elder care advocates is the $150 billion dedicated to Medicaid home and community services, along with regulations leading to a federally required nursing home staffing standard. Also, the bill does not include any estate tax changes. There is much more in the bill (or out of the bill, depending on your perspective). You [...]

2024-07-29T11:59:20-04:00November 4, 2021|

Arbitration Agreements in Nursing Home Admission Contracts

  On October 1st, a federal appeals court decided to uphold restrictions that limit the use of binding arbitration agreements in nursing home admissions agreements. Binding arbitration agreements prior to the rise of any actual dispute have been promoted for decades as a way to reduce expenses by providing an alternative dispute resolution method. When used properly, arbitration agreements can provide the parties with a less expensive forum to solve disputes. However, binding arbitration agreements have also been used by the business community to attempt to limit themselves from potential liability by having a party relinquish their right to bring [...]

2024-03-08T12:15:04-05:00October 8, 2021|

LGBTQI+ Senior Bill of Rights

New Jersey is one of four states leading the charge against discrimination based on sexual orientation in long-term care facilities. In March of this year, Governor Murphy signed S2545/A4388, known as the LGBTQI+ Senior Bill of Rights, into law. The new law, similar to those in Massachusetts, California, and Illinois, bans discrimination in long-term care communities based on gender identity and sexual orientation.   The significance of the LGBTQI+ Senior Bill of Rights is twofold. First, it mandates the staff and administration of long-term care communities receive training on caring for and preventing discrimination against LGBTQI+ seniors. Secondly, the law establishes [...]

2024-03-08T12:23:42-05:00July 22, 2021|
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