On November 17, 2021, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) issued Advisory Opinion No. 21-18 that addresses the provision of therapy services in various types of long-term care communities, including skilled nursing facilities (SNFs), assisted living facilities (ALFs), and full-service continuing care retirement communities. The OIG concluded that joint ventures between therapy companies and long-term care communities violate the federal Anti-Kickback Statute.
Home health providers have often expressed concern about so-called “therapy rooms” in long-term care facilities. From the point of view of home health providers, including marketers, the use of “therapy rooms” for outpatient therapy services, as opposed to home health services, may be problematic. Patients who may benefit from other services provided by home health agencies, such as nursing and home health aides, may not receive these services when referred to outpatient therapy. In addition, patients may be required to pay co-payments for outpatient therapy services billed to Part B when they could, in many instances, receive therapies from home health agencies with no co-payments.
The recent Advisory Opinion may put a damper on some arrangements between therapy companies and long-term care communities. The facts upon which the Advisory Opinion is based are that a contract therapy services company that provides management of day-to-day operations and therapy staffing for rehabilitation programs would enter into joint ventures with companies that directly or indirectly own long-term care communities. Joint venture entities would provide contract therapy services to rehabilitation programs in the communities.
Please join this webinar presented by Elizabeth E. Hogue, Esq., to learn why your home care agency needs to avoid these types of joint ventures and to carefully review your current contractual arrangements to determine whether they violate the OIG’s prohibition on contractual joint ventures.
Elizabeth E. Hogue, Esq.
Elizabeth E. Hogue is an attorney in private practice with extensive experience in health care. Prior to becoming an attorney, she was employed as a personnel manager by a Blue Cross-Blue Shield health plan. She studied at the University of Maryland School of Law, concentrating in health law, and gained considerable clinical experience, course work, and employment experience in this area. Following her admission to the Bar, she developed an active practice in health law. She represents clients all over the country. Her clients are professional associations, physicians, managed care providers, and institutional health care providers, including hospitals, long-term care facilities, home health agencies, durable medical equipment companies, private duty agencies, and hospices. She has also represented a number of individual providers and case managers concerning health-related issues.
Ms. Hogue gives approximately 20 presentations each year on health-related topics, including future trends in the healthcare industry. Her numerous articles are regularly included in trade association publications and other journals. She has written extensively on health-related topics. Her books include Nursing Case Law Reporter, Informed Consent, Legal Liability, Medicare/Medicaid Fraud and Abuse, Contracting with Managed Care Providers, Ethics Manual, Termination of Services to Patients: Use of Policies and Procedures to Avoid Liability for Abandonment, Case Management: Legal Issues, How to Develop a Fraud and Abuse Compliance Plan, How to Form Alliances Without Violating the Law, Wound Care: Legal Issues, and How Marketers Can Get Referrals Without Breaking the Law. Ms. Hogue is a member of the American Health Lawyers Association.
Attendees will receive 1.0 continuing education unit for skilled nursing, occupational therapy, speech therapy, and accounting. Approval for 1.0 physical therapy continuing education unit is currently pending.
HCAF offers a multitude of ways for home care industry vendors to promote their products and services, including education program sponsorships. For more information on this event, please click here.
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Register online or call (850) 222-8967 to register by phone. HCAF members receive a discounted registration rate! To obtain the member discount, please log in to your profile before registering.
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