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Homeostasis: Health Care Law Blog

Posts by Andrew T. VanEgmond


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Showing 5 posts by Andrew T. VanEgmond.

Resident Discharge From a Michigan HFA: A Reminder

In Michigan, licensed homes for the aged are a sort of regulatory hybrid, wedged in between heavily regulated skilled nursing facilities and unlicensed assisted living facilities. That middle ground is apparent in the degree to which the Michigan Department of Licensing and Regulatory Affairs (“LARA”) is involved in the facility’s relationship with its residents during discharge situations. Although a licensed home for the aged (“HFA”) is not subject to the detailed procedures for involuntary discharge that apply to skilled nursing facilities, HFAs are not free to approach the eviction process like the typical commercial senior housing landlord. Rather, a licensed HFA must ensure it has met LARA’s discharge requirements before even beginning the eviction process. If not, all its efforts may be for naught. Read More ›

Supreme Court Exposes FCA Defendants To Decade-Old Relator Suits

When the Supreme Court accepted the cert petition to resolve a Circuit split regarding the False Claims Act’s statute of limitations when the government does not intervene, it created the potential that the Court would extend the limitations period for private relators’ FCA actions. That is exactly what happened. The Supreme Court unanimously ruled that a relator can bring suit within three years after a government official knows, or should know, about a potential FCA violation—up to 10 years after the underlying event—and the relator does not count as a government official. Cochise Consultancy, Inc. v. United States ex rel. Hunt, No. 18-315 (U.S. May 13, 2019). FCA defendants may, therefore, face more qui tam suits reaching further back into their memories and records. Read More ›

A Longer Statute of Limitations for False Claims Act Qui Tam Suits?

A Supreme Court case to be decided this term will determine whether to extend the statute of limitations for private relators’ FCA actions in which the government does not intervene. United States ex rel. Hunt v. Cochise Consultancy, 2018 U.S. LEXIS 6778, at *1 (Nov. 16, 2018). The Department of Justice wants relators to have the same 10 year statute of limitations as the government has in cases where the government does intervene. Read More ›

OIG Puts SNF Involuntary Discharges and Transfers Under the Microscope

Increased federal oversight may be on the horizon for skilled nursing facility involuntary transfers and discharges. The Office of Inspector General (OIG)  included in  its 2019 Work Plan reviewing SNFs’ involuntary transfers and discharges, focusing on reviewing whether State agencies have effectively investigated and enforced proper transfer and discharge procedures. Now is the time for SNFs to review their involuntary transfer and discharge procedures to make sure they are in compliance with CMS regulations. Read More ›

Covenant FN 40: A Silver Lining for Health Care Providers?

The Covenant Med. Ctr., Inc. v. State Farm Mut. Auto. Ins. Co., decision last year posed new problems for health care providers seeking to litigate no-fault benefit payment disputes against insurance companies. The Michigan Supreme Court held that providers could no longer bring direct causes of action against no-fault insurance companies for payment denials or underpayments because the no-fault statute does not mention any such cause of action. However, Footnote 40 of the Court’s opinion offered another option: the health care provider can enforce an assignment of past or present—not future—benefits from the patient. If the patient signs an assignment of benefits form at the time of each service, the health care provider can bring an action against the no-fault insurer on behalf of the patient. It remained unclear though how Michigan courts would interpret this footnote and whether the courts would impose additional restrictions on providers’ use of assignments to litigate payment disputes with no-fault insurers. Recent case law clarifies how providers may use Footnote 40. Read More ›