Long Term Care & Senior Living Blog

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.

The Environmental Protection Agency (EPA) has proposed changes that may impact the way pharmaceuticals, especially those containing hazardous waste ingredients, are handled through reverse distribution. Organizations generating pharmaceutical waste including pharmaceutical companies, hospitals, long-term care facilities and physicians groups may be impacted. The following excerpt comes from the EPA website.

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.