The OIG Updates FAQs Related to Arrangements Directly Connected to the COVID-19 Public Health Emergency

The Office of Inspector General (OIG) is highlighting their commitment to protecting patients by ensuring that health care providers have the regulatory flexibility necessary to adequately respond to COVID-19 concerns. In a series of FAQs, the OIG is responding to provider questions regarding administrative enforcement authorities, including the federal Anti-Kickback Statute and civil monetary penalty provision prohibiting inducements to beneficiaries. On May 14, 2020, the OIG published its most recent response to an inquiry about the provision of face masks at no or reduced cost by physician groups to skilled nursing facilities. In the FAQ, the OIG outlines its considerations for extending enforcement flexibility during the current public health emergency.

To read the full response, visit: https://oig.hhs.gov/coronavirus/authorities-faq.asp

New California Bill Introduced Regarding Residents Affected by Skilled Nursing Facility Closures

On February 2, 2017, California Assemblymember Jim Wood (D-Healdsburg), introduced AB 275 that would provide certain protections to residents of skilled nursing facilities (SNFs) when those facilities have a change in license status or operation, such as closure.  

Among other changes, AB 275 requires facilities to provide 90 days’ notice to residents and, if resident’s concerns cannot be appropriately addressed, the California Department of Public Health (CDPH) can extend this period for another 90 days. The bill requires a resident assessment by both a physician and mental health professional and gives CDPH the authority to require a resident transfer plan to assure that residents’ needs have been considered. Last, whenever two or more SNFs propose to close on the same date, the SNFs will be required to prepare a comprehensive community impact report. 

Read the text of the bill here: http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB275.

Skilled Nursing Operator to pay $170,000 for Falsifying Records

Autumn Health Care of Zanesville and its owner, Steven Hitchens, both pleaded guilty to multiple charges in October following an investigation that revealed that the organization, including Hitchens and a number of facility managers had altered, forged, and, in some cases, destroyed records in order to maintain Medicare and Medicaid funding.

Among the charges against Hitchens and Autumn Health Care are: 

• providing unnecessary skilled therapy to Medicaid residents and billing Medicare Part B to pay for these unnecessary medical services; 

• falsely reporting unnecessary medical services in order to receive a higher reimbursement rate from the Ohio Department of Medicaid; 

• systematically falsifying resident records to defraud the Ohio Department of Health in an effort to make it appear that missed medical treatments were actually provided;

• destroying a record outlining an incident involving an ill resident who was found in a snow bank after escaping the facility and forging a new record that falsely described the incident in order to avoid a citation from the Ohio Department of Health. 

• forging a registered nurse's signature on resident assessments that were electronically sent to the Ohio Department of Health to bypass a requirement that a registered nurse certify the accuracy of the assessment.

The organization will be required to repay more than $52,000 to the Ohio Department of Medicaid, and an additional $40,000 in investigative costs to Attorney General Mike DeWine’s Office. Hitchens was ordered to serve three years of community control, 100 hours of community service, and is now under a period of federal exclusion from the Medicare and Medicaid programs as a result of his conviction.

Additionally, several of the organization’s managers and employees were all also sentenced to community controls and are under a period of federal exclusion from the Medicare and Medicaid programs. As a result, to their convictions, the Ohio State Board of Nursing permanently revoked the nursing licenses of all the nurses convicted of felonies.

For more information regarding this case visit: http://www.mcknights.com/news/provider-to-pay-nearly-170000-for-falsifying-destroying-records/article/630792/?DCMP=EMC-MCK_Weekly&spMailingID=16320456&spUserID=MTM0NDIzMDk1MDgwS0&spJobID=940972772&spReportId=OTQwOTcyNzcyS0