The Association of American Physicians and Surgeons is sounding the alarm on the abusive use of CPG's against doctors.  Instead of being treated as guidelines, they are being treated as mandates to quash robust debate and to curtail independent medical judgment of physicians: “CPGs are based entirely on consensus,” Dr. Huntoon writes. “They are often influenced or driven by profit, cost containment, and politics, and may vary widely depending on the underlying incentives of … [Read more...] about Misuse of Clinical Practice Guidelines

                                On June 1, 2021, the U.S. Supreme Court ruled in the qui tam case,  U.S. ex rel. Schutte v. SuperValu Inc , that the scienter (intent or knowledge of wrongdoing) element of the False Claims Act is the defendant's "knowledge and subjective belief" as opposed to what an objectively reasonable person may have known or believed.   This overturns some other circuits' … [Read more...] about Interesting Supreme Court Case Regarding the False Claims Act

  As of January 1, 2023, appeal cases for Home and Community-based Services and Texas Home Living administrative penalties, contract terminations, vendor holds, recoupments, and denial of payment from the HHSC Appeals Division to the Texas State Office of Administrative Hearings (SOAH).  The rules also clarify that both Long-term Care Regulation and Provider Investigations employee misconduct registry cases for any LTCR-regulated provider type will be heard by SOAH. Here are the new … [Read more...] about New Appeals Rules Effective 1-1-23

The DOL continues its efforts to rule over American businesses in a "one-size fits all" approach.  Its hatred of independent contracting once again emerges.  Then, of course, after further exacerbating staffing problems, the government will fine you for any issues in care arising from not having enough people to render care. … [Read more...] about Proposed Worker Classification Rule

New York’s Richmond County Supreme Court recently ordered workers fired for refusing to take the vaccine and whose requests for exemptions were denied the reinstated with back pay. One of the most important statements made by the court was that being vaccinated does not prevent an individual from contracting or transmitting Covid 19. Being vaccinated does not prevent an individual from contracting or transmitting Covid-19. As of the day of this Decision, CDC guidelines regarding quarantine … [Read more...] about Dawn Begins to Break

This was posted on March 21, 2022.   "New 40 TAC §90.50, regarding emergency preparedness and response, requires an ICF/MR, whether licensed or exempt from licensure, to develop an emergency preparedness and response plan that addresses the core functions of emergency management. This rule requires an ICF/MR to designate an emergency preparedness coordinator, a facility staff person who has the authority to manage the facility’s response to an emergency situation in accordance with the … [Read more...] about ICF-MR–New Texas Provider Letter on Emergency Preparedness and Safety Operations

Last Friday, CMS  issued a memo to State Survey Agency Directors directing increased scrutiny of Nursing Homes.  According to Mcknight's, this means: "Surveyors are being directed to place special attention on things such as nurse staff abilities and actions, use of antipsychotics and areas of care where residents’ health and safety may be at an increased risk. That means having a more critical eye on unplanned weight loss, loss of function/mobility, depression, abuse/neglect or pressure … [Read more...] about Tougher Surveys for Nursing Homes on the Horizon