Long Term Care & Senior Living Blog

As many of you are aware, on January 1, 2016, the Illinois Authorized Electronic Monitoring in Long-Term Care Facilities Act (the “Act”) became effective. This Act imposes various responsibilities on long-term care facilities in Illinois to allow residents to engage in electronic monitoring. The Department of Public Health (“IDPH”) also has certain responsibilities under the Act. The following Summary provides highlights of the background and requirements of the Act, IDPH and facilities’ respective responsibilities, and challenges presented for the facilities subject to the Act along with a few recommended actions in response to the Act. There’s also a link to the Consent and Notification Form promulgated by IDPH for use when a resident desires to use an authorized electronic monitoring device in a facility. If you have clients subject to this Act, you may want to pass this information along to them. I would be happy to answer any questions or provide additional information, if needed.

Rep. Elaine Nekritz (D-Buffalo Grove) Introduced HB 3300 to the Illinois General Assembly on February 26, 2015, amending the Nursing Home Care Act by removing the provision permitting the award of costs and attorney’s fees. Under the current statute, 210 ILCS 45/3-602, facility residents who prevail on a claim asserting a violation of their rights are entitled to recover costs and attorney’s fees, in addition to actual damages. Under HB 300, facility residents would only be permitted to recover actual damages.

The Department of Justice (DOJ) announced a settlement for claims of substandard nursing care and medically unnecessary rehabilitation therapy wherein Extendicare will pay $38 million to settle False Claims Act allegations. Rehabilitation services have been a frequent target for DOJ investigation and settlement of alleged overpayments. Once again, DOJ brings closure to an investigation of an initiative from the Health Care Fraud Prevention and Enforcement Action Team (HEAT). In addition to HEAT, this settlement arose from an investigation related to the Justice Department’s Elder Justice initiative, which coordinates the Office of Inspector General (OIG) efforts to combat elder abuse, neglect and financial exploitation.

False Claims Act (FCA) allegations are serious business. Anti-Kickback Statute prohibits offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid and other federally funded programs. Omnicare learned the hard way just how serious FCA actions can be when a whistleblower made allegations against it.

Next time you wonder how serious the government is about anti-kickback law, think about the latest False Claims Act settlement of $30 Million. This settlement was part of the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, partnering Department of Justice and Health and Human Services.