Sunday, October 15, 2006

NAHC Legal Update

One of my favorite people in home care in Bill Dombi, Vice President for Law at NAHC. Bill is always on top of what's happening in our industry, and presents the latest updates from the legal front. And, he's fun and funny.

During the opening general session, Bill updated us on :

Coke vs. Long Island Home Care

This is a case where a home care aide is suing her employer over entitlement to overtime pay. The case has the potential of invalidating the "Companionship Services" exemption under Federal Law. The case is being appealed in the 2nd Circuit Court, and may well go to the U.S. Supreme Court.

Fraud And Abuse

Bill described a case in California where a company pleaded guilty of falsifying claims by having people sitting in a room creating paperwork to document home care visits and episodes that never took place. They entered a guilty plea and already $33 million has been recovered. Several physicians are being investigated and could be indicted.

We all need to be concerned about unsavory characters entering our home care community and giving all of us a bad name with CMS, the OIG, and the citizens of our communities.

Price Waterhouse Coopers Study

Bill described a study that is being conducted for NAHC by PwC to evaluate the methods being used by MedPAC, the Medicare Payment Advisory Committee, to assess the financial health of home care companies by using national margins. The early findings suggest that the methodology being used by MedPAC do not accurately portray the true financial health of our industry.

Bill also introduced the new Deputy Director for the Center for Home Care Law, Denise Bonn.

What do you think about these legal issues? What are your concerns about reimbursement and regulatory issues? Add your comments below using the "Comment" button.

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