Hurricane Resources for Bar Members; November Web Audio Seminar

2017 Hurricane Information

Find out more about our Florida Bar Member Benefit providers offering enhanced benefits to members affected by Hurricane Irma, including complimentary additional services or extended complimentary trial periods.

The Florida Bar 2017 Hurricane Information Page

Web Audio Seminar: November 14, 2017

Course Number: 270

CLE Credits: General 1.0; Certification: Health Law 1.0

Topic: Compliance Basics: What Every Health Care Lawyer Should Know

Speaker : Timothy Wombles

Description: This presentation will cover a wide range of laws applicable to health facilities, from the Anti-Kickback Statute to the Stark Law and beyond. Topics discussed will also include legal developments in false claims litigation, including recent trends in cases where the government declined to intervene.    

http://tinyurl.com/FloridaBarCLE2701R

Master Class on Telemedicine - New Date

Begun as the “FUNdamentals of Health Law” series by “Chet” Barclay in 2009, the 9th installment of the series does a “deep dive” into the legal, ethical, and technological issues surrounding remote diagnosis and treatment using technology, usually referred to as telemedicine or telehealth. The program is designed to be immediately useful to attorneys, health care professionals, and health technology professionals needing to understand more thoroughly the issues and problems created by the expanding use of technology to treat patients other than at the bedside. Morning and afternoon sessions will be followed by interactive panel discussions among faculty and both on-site and Internet attendees. Comprehensive materials will be provided.

TO REGISTER FOR THE LIVE COURSE, PLEASE CLICK THE LINK BELOW AND THEN LOG IN TO THE FLORIDA BAR MEMBER PORTAL.

https://member.floridabar.org/eventAPI__router?event=a1R360000024RCz

Details

COURSE CLASSIFICATION: ADVANCED LEVEL

Live and Webcast Presentation: Friday, December 8, 2017

Rosen Centre Hotel
9840 International Drive
Orlando, FL 32819
(407) 996-9840 

CLER CREDITS

CLER PROGRAM
(Max. Credit 8.5 hours)
General 8.5
Ethics 1.0
Substance Abuse 1.5
Technology 3.5

CERTIFICATION CREDITS
Health Law 8.5

In-Person Attendance:  

Health Law Section Member: $235.00

Non-Section Member: $265.00

Webcast Registration

In order to register for the webcast, go to: http://tinyurl.com/floridabarcle2550R

  • Section Member........................................$285

  • Non- Section Member...............................$315

Please call  (850) 561-5831 for assistance with registration and ordering

Health Care Regulatory and Compliance Seminar

This seminar is meant to provide Florida lawyers and compliance officers a great overview of health care regulatory and compliance issues impacting a range of providers.  A wide range of topics will be covered.  The areas that will be covered range from federal and state fraud abuse provisions, ethics, HIPAA, HITECH and Florida Information Protection Act to regulatory issues in the 2018 legislative session as well as recent cases. 

COURSE CLASSIFICATION : ADVANCED LEVEL

Live and Webcast Presentation: Friday, November 3, 2017

Renaissance Fort Lauderdale Cruise Port Hotel

1617 SE 17th Street
Fort Lauderdale, FL 33316
(954) 626-1700

CLER CREDITS

CLER PROGRAM
(Max. Credit 7.0 )
General 7.0
Ethics 1.0


CERTIFICATION CREDITS
Health Law 7.0

In-Person Attendance:

  • Health Law Section Member: $275.00
  • Non- Section Member: $305.00

Webcast Registration:

In order to register for the webcast, go to: http://tinyurl.com/floridabarcle2573R

  • Section Member......................................$325
  • Non- Section Member..............................$355
     

Please call (850) 561-5831 for assistance with registration and ordering.

Information and Registration Link: https://member.floridabar.org/CPBase__event_detail?id=a1R360000025csQEAQ

Executive Council Meeting Rescheduled

Thursday, December 7, 2017

3:30 p.m. -5:30 p.m.  

Rosen Centre Hotel

9840 International Drive

Orlando, FL 32819

 

Legislative Bills Filed February 28, 2012

The following bills were filed on February 27 and 28, 2012.

HB 7133 Relating to Quality Improvement Initiatives for Entities Regulated by the Agency for Health Care Administration (Health & Human Services Committee)

Quality Improvement Initiatives for Entities Regulated by the Agency for Health Care Administration: Provides responsibilities of DCFS & mental health service providers for me ntal health residents who reside in ALFs; provides for imposition of contract penalties on Medicaid prepaid health plans & mental health service providers; provides for interagency agreement between DCFS & AHCA; requires specified information regarding confidentiality of complaints to State Long-Term Care Ombudsman Program to be provided to residents of long-term care facilities upon admission; directs agency to establish & implement methodologies to adjust Medicaid rates for hospitals, nursing homes, & managed care plans; provides criteria for & limits on amount of Medicaid payment rate adjustments; directs agency to seek federal approval to implement performance payment system; provides applicability of performance payment system to general hospitals, skilled nursing facilities, & managed care plans; provides that specified persons who have regulatory responsibilities over or provide services to persons residing in ALFs must report suspected incidents of abuse to central a buse hotline; requires ALFs to be under management of licensed administrator; provides training & licensure requirements for administrators; authorizes agency to issue temporary license to administrator; provides additional requirements for limited mental health license; provides fines & penalties for specified violations by ALF; directs DEA to create advisory council to review circumstances of unexpected deaths in ALFs & of elopements; provides schedule for inspection of ALFs; provides that AHCA, DEA, DCFS, & APD shall develop or modify electronic information systems. Effective Date: July 1, 2012

SB 2134 Relating to Share Your Spare Act/Kidney Transplant (Smith (C))

Share Your Spare Act/Kidney Transplant; Urging Congress to pass the Share Your Spare Act, H.R. 2755, and the Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patie nts Act, H.R. 2969 and S. 1454, etc.

Legislative Bills Filed February 17, 2012

SB 1990 - Relating to Developmental Disabilities (Budget)

Developmental Disabilities; Requiring that the Agency for Persons with Disabilities review a waiver support coordinator’s performance to ensure that the support coordinator meets or exceeds criteria established by the agency; requiring that the area office review the amount of funding needed to address the each client’s extraordinary needs in order to determine the medical necessity for each service in the amount, duration, frequency, intensity, and scope that meets the client’s needs; authorizing the agency to consult with the Department of Health, the Agency for Health Care Administration, the Department of Business and Professional Regulation, and the Department of Agriculture and Consumer Services concerning procedures related to the storage, preparation, serving, or display of food and procedures related to the detection and prevention of diseases caused by certain factors in the environment, etc. Effective Date: July 1, 2012

SB 1988 - Relating to Medicaid (Budget)

Medicaid; Deleting a prohibition preventing children who are eligible for coverage under a state health benefit plan from being eligible for services provided through the subsidized program; requiring a completed application, including a clinical screening, for enrollment in the Children’s Medical Services Network; updating references to data used for calculations in the disproportionate share program; providing an additional site in Broward County for the Program of All-Inclusive Care for the Elderly, etc. Effective Date: except as otherwise expressly provided in this act and except for section 23, which shall take effect upon this act becoming a law, this act shall take effect July 1, 2012

March-April 2017 Health Law Updates

Dear Health Law Section Members:

The following articles involve significant developments in the health law arena that may be of interest to you in your practice. These summaries are presented to Section members for general information only and do not constitute legal advice from The Florida Bar, its Health Law Section, or the authors of these summaries.

HLS thanks the following volunteers who have generously donated their time to prepare these summaries for our members:

  • Elizabeth Scarola, Esq.

  • Yesenia Fatima Lara, Esq.

  • Christian Pérez Font, Esq

  • Rodney Johnson, Esq.

Thank you.

Malinda Lugo, Esq.

Kimberly Sullivan, Esq.

You may download a copy of the summaries as well as read them, below.

document March April Heath Law Updates 2017 (DOCX) (23 KB)

pdf March April Health Law Updates 2017 (PDF) (153 KB)


COMPLIANCE

Owner of South Florida Home Healthcare Owner indicted in $15MM Medicare Fraud Scheme

On March 14th, 2017, the Department of Justice announced that it had indicted the owner of Elite Home Care, LLC, a Miami-based home healthcare provider, with one count of conspiracy to commit health care fraud and wire fraud, two counts of health care fraud and one count of conspiracy to defraud the United States and pay health care kickbacks. According to the indictment, aside from filing documents in an effort to conceal his ownership of the home healthcare provider, the defendant engaged in other illegal practices that included the payment of kickbacks to Medicare beneficiaries and patient recruiters in exchange for referrals. As a consequence of this scheme, Medicare paid approximately $ 15MM in false claims. The case is still ongoing and the defendant is presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.

A copy of the Department of Justice’s press release is available at https://www.justice.gov/opa/pr/south-florida-home-health-owner-charged-role-15-million-medicare-fraud-scheme.

Christian Pérez Font, Esq

Two Defendants plead guilty to $20MM Medicare Fraud Scheme at Seven Miami Area Home Health Agencies

 On March 2nd, 2017, the owners and operators of seven home healthcare agencies in the Miami area plead guilty to charges of conspiracy to commit healthcare fraud, healthcare fraud and wire fraud. As part of their pleas, the defendants admitted that they recruited nominees to conceal their ownership interest in these agencies and that they also engaged in a scheme to pay bribes and kickbacks to healthcare professionals in return for the provision of prescriptions for home healthcare services and referrals of Medicare beneficiaries many of which did not even these services. According to the Department of Justice’s press release, Medicare improperly paid approximately $ 20MM to these seven agencies.

A copy of the Department of Justice’s press release is available at https://www.justice.gov/opa/pr/two-women-plead-guilty-orchestrating-20-million-medicare-fraud-scheme-seven-miami-area-home

Christian Pérez Font, Esq


FRAUD AND ABUSE

Developments in Medicare Secondary Payer Law

Two recent legal decisions out of the Eleventh Judicial Circuit in and for Miami Dade County indicate that Medicare Advantage Organizations (MAOs) may be able to obtain reimbursement from no-fault liability carriers pursuant to Medicare Secondary Payer law on a class-wide basis. On April 20, 2017, the Honorable Judge Antonio Arzola entered a 56-page order granting class certification to a class of approximately 37 Florida MAOs. MSPA Claims 1, LLC v. IDS Property Cas. Ins. Co., No. 2015-27940 (Fla. 11th Cir. Ct. Apr. 20, 2017). The allegations are mainly that IDS Property Casualty Insurance Company: 1) failed to properly pay the personal injury protection benefits for their insureds who were also Medicare beneficiary; and 2) failed to provide appropriate reimbursement for conditional payments provided by the MAOs on behalf of Medicare enrollees.

This is only the second time in the United States where class certification has been obtained for Medicare Advantage Organizations based on the principles of Medicare Secondary Payer law. The first class certification came on February 3, 2017, from the Honorable Judge Samantha Ruiz Cohen. See MSPA Claims 1, LLC v. Ocean Harbor Cas. Ins., No. 2015-1946 (Fla. 11th Cir. Ct. Feb. 3, 2017). The order can be located at: http://msprecoverylawfirm.com/wp-content/uploads/2017/02/15-1946plfordergranting20Signed20Order.pdf.

Both state and federal courts are recognizing that Medicare Advantage Organizations are paying for health benefits for which no-fault carriers are primarily responsible. The Medicare Secondary Payer law provides MAOs with the same recovery rights as CMS and is meant to counteract rising healthcare costs. There are several similar nationwide putative class actions being pursued on behalf of MAOs against large insurers such as Allstate and State Farm. The road ahead in these class action cases may be long and winding, but certainly these cases are shaping the world of Medicare Secondary Payer law and MAOs.

Yesenia Fatima Lara, Esq.

 


PUBLIC HEALTH

Updated Criminal and Epidemiological Investigations Handbook.

CDC has released an updated version of to the Criminal and Epidemiological Investigations Handbook. This latest version provides an overview of criminal and epidemiological investigation procedures involving interactions between law enforcement and public health. The handbook will teach public health and law enforcement how to work together to identify the biological agent, prevent the spread of the disease, avoid public panic, and apprehend those responsible. It is also available in French and Spanish. The updated handbook can be found at:

https://www.cdc.gov/phlp/docs/crimepihandbook2016.pdf

Rodney Johnson, Esq.

 

CMS Requires Participating Providers to Prepare for Emergencies

On March 24, 2017, the Centers for Medicare & Medicaid Services (CMS) released a memorandum encouraging participating providers to “seek out and participate in a full-scale, community-based exercise with their local and/or state emergency agencies and health care coalitions and to have completed a tabletop exercise by [November, 2017].”

The memo is intended to assist providers and suppliers with meeting the testing and training requirements of the September 2016 emergency preparedness final rule.

The final rule requires participating providers to plan for natural and man-made disasters, train for disaster preparedness and test emergency plans.

The memo clarified that participating providers are expected to meet the requirements of the final rule by November 15, 2017, or face citations for non-compliance.

Facilities that are unable to complete a full-scale emergency preparedness exercise by November 15, 2017 are encouraged to undergo an individual facility-based exercise and document the circumstances as to why a full-scale, community-based exercise was not completed.. More information is available at:

https://www.cms.gov/medicare/provider-enrollment-and-certification/surveycertemergprep/emergency-prep-rule.html

Elizabeth Scarola, Esq.


 

THIRD PARTY PAYORS

Mandatory Bundled Payments Delayed, CMS seeking comments

CMS Administrator, Seema Verma, and Secretary of Health and Human Services Secretary, Tom Price delayed implementation of the Comprehensive Care for Joint Replacement (“CJR”) program via an interim final rule. See CMS – 5519 – IFC

The effective date of CJR model implementation originally set for March 21, 2017 was delayed until May 20, 2017. Accordingly, the applicability of the CJR regulations at 42 C.F.R. part 512 are now set to begin on October 1, 2017.

This interim final rule also delays the implementation of other mandatory bundled payment models, including the Cardiac Rehabilitation Incentive Payment Model.

CMS is seeking comment on the appropriateness of the possibility of further delaying the start of these mandatory models until January 1, 2018.

CMS reasons,

… delay is necessary to … ensure that the agency has adequate time to undertake notice and comment rulemaking to modify the policy if modifications are arranged, and to ensure that in such a case participants have a clear understanding of the governing rules and are not required to take needless compliance steps.

Many have speculated about the future of bundled payments under the Trump Administration.

While serving as a member of Congress, HHS Secretary Tom Price publicly opposed CMS’ mandatory initiatives, like CJR. Then Rep. Price urged CMS via a signed letter to “cease all current and future planned mandatory initiatives.” Last year, he also introduced a bill (H.R. 4848) co-sponsored by Rep. David Scott (D-GA) that would have delayed the implementation date of the CJR model until January 1, 2018.

Providers concerned with the feasibility of implementing the CJR model and other mandatory bundled payment initiatives within the current year are urged to submit comments to CMS.

Questions regarding the interim final rule may be submitted to CMS via email at CJR@cms.hhs.gov

Elizabeth Scarola, Esq.