The Centers for Medicare & Medicaid Services (CMS) has instructed state survey agencies that they must conduct onsite complaint investigations related to Emergency Medical Treatment and Labor Act (EMTALA) complaints and surveys of death in restraint or seclusion in hospitals and critical access hospitals within two business days instead of five. This change brings these … Continue Reading
On the heels of its proposed rule to expand its health program exclusion authority, the Office of Inspector General (OIG) of the Department of Health and Human Services has published a proposed rule that would amend the health care program civil monetary penalty (CMP) regulations. The rule would codify the OIG's expanded statutory authority under the Affordable Care Act to impose CMPs on providers and suppliers and would allow for significant penalties in a variety of scenarios, some of which could extend beyond what is currently permitted.
Reed Smith attorneys have prepared a Client Alert summarizing and analyzing the OIG's proposed rule, including the various scenarios under which CMPs could be issued under the proposed regulations, such as: failure to report and return an overpayment; failure to grant OIG timely access to records upon request; ordering or prescribing items or services while excluded from a federal health care program, as well as arranging or contracting with an individual or entity who meets this criteria; making false statements or omitting or misrepresenting material facts in an application, bid, or contract; and failing to submit or certify drug-pricing and product information in a timely manner. In addition, the alert covers the changes in technical language proposed by OIG to clarify and more clearly define the scope of CMP regulations.… Continue Reading
On March 22, 2012, the House approved by a 223-181 vote H.R. 5, the “Protecting Access to Healthcare Act,” which would repeal the ACA’s controversial Independent Payment Advisory Board (IPAB), paid for with medical liability reforms. IPAB is charged with submitting detailed proposals to Congress and the President to reduce Medicare per-capita spending if projected … Continue Reading
On February 2, 2012, CMS published a request for comments on the applicability of the Emergency Medical Treatment and Active Labor Act (EMTALA) to hospital inpatients. Current EMTALA rules provide that when an individual comes to a hospital’s emergency department, and the hospital provides an appropriate medical screening examination and determines that an emergency medical … Continue Reading
On December 23, 2010, CMS published an advance notice of proposed rulemaking soliciting comments on the need for a proposed rule to address two policies related to the Emergency Medical Treatment and Labor Act (EMTALA). Specifically, CMS is requesting comments regarding its need to revisit rules adopted in 2003 and 2008 concerning the applicability of EMTALA … Continue Reading
CMS has recently issued guidance to state survey agencies on a number of issues, including: Interpretive Guidelines for Long-Term Care Facilities (infection control programs); Surveying Facilities That Use Electronic Health Records; EMTALA Requirements and Options for Hospitals in a Disaster; Clarification of Ambulatory Surgical Center Interpretive Guidelines; Initial Surveys of CAH Distinct Part Units Changed to … Continue Reading