Compliance News Roundup: Long Term Care Final Rule

Welcome to our weekly Compliance News Roundup. We scour the headlines in search of breaking healthcare compliance news so you don’t have to.

1. Nursing home operator from Chicago jailed as feds allege $1 billion scheme - "'This is the largest single criminal health care fraud case ever brought against individuals by the Department of Justice,' Assistant Attorney General Leslie Caldwell said at a July 22 news conference announcing the charges.” Read more here: http://www.chicagotribune.com/news/watchdog/ct-philip-esformes-jailed-met-20161002-story.html

2. DOJ Approach To Skilled Nursing Facility Fraud Is Affirmed - ”In recent years, the skilled nursing facility industry has become a major focus of the federal healthcare programs and the DOJ’s enforcement efforts under the False Claims Act. The reasons are clear — Medicare pays over $30 billion each year to skilled nursing facilities, which along with Medicaid covers millions of mostly elderly and infirm Americans residing in nursing homes.” Read more here: http://www.law360.com/articles/848159/doj-approach-to-skilled-nursing-facility-fraud-is-affirmed

3. The Final Rule: Deeper Than The Headlines - “The Final Rule is a major overhaul of the requirements for SNFs to participate in Medicare and Medicaid. The requirement to maintain a “Compliance and Ethics Program,” is among the many provisions.
A huge takeaway from the final rule is that compliance programs can no longer be an afterthought. One of the requirements is that the organization “must provide sufficient resources to reasonably assure compliance with the program’s standards, policies, and procedures.” Read more here: Deeper Than the Headlines: Long Term Care Final Rule