Literature Review

New FTC regulations could create obstacles for hospice M&A Hospice News; by Jim Parker; 10/24/24 Changes to federal rules governing mergers and acquisitions could have sweeping effects on hospice and other health care transactions. The Federal Trade Commission (FTC) recently finalized a rule that will implement changes to required pre-merger notification forms. Pursuant to the Hart-Scott-Rodino Act, parties to certain transactions must submit these documents to the FTC and other regulatory agencies to help identify and address potential antitrust concerns. The law requires that transactions exceeding $120 million must submit the form, which agencies will use to conduct a 30-day premerger assessment, according to Luke Smith, member at the law firm Bass, Berry and Sims. The final rule will likely complicate the closing of some hospice acquisitions.

Empowering patient access, protection, and choice: The 21st Century Cures Act eight years on Healthcare Business Today; by David Navarro; 7/26/24 The 21st Century Cures Act, signed into law in December 2016, marked a significant shift in the healthcare landscape by focusing on patient empowerment through enhanced access to medical records, stringent privacy protections, and increased choices in healthcare options. Eight years later, this landmark legislation continues to revolutionize the interaction between patients, providers, and the healthcare system. Recently, The U.S. Department of Health and Human Services (HHS) issued an updated ruling to the Act to establish penalties for healthcare providers who engage in information blocking. This rule, aims to deter practices that prevent or discourage the access, exchange, or use of electronic health information (EHI).

Hospice care provider embroiled in federal health care fraud allegationsMarketBeat; by Due.com; 7/18/24A hospice care provider has been at the center of allegations that it may have defrauded federal health care programs. According to court documents, Kindred at Home was accused of knowingly defrauding the U.S. government. The umbrella organization operated out of Atlanta and had multiple splinter branches, including Avalon, Kindred, SouthernCare, and SouthernCare New Beacon. Kindred at Home has now agreed to quash the allegations. The federal watchdogs’ grilling resulted in a financial penalty and closed nine separate lawsuits. ... Kindred has agreed to pay $19.428 million to resolve allegations. The federal government will receive $18,956,151.32, the State of Tennessee will receive $448,800 and the State of Ohio will receive $23,618.68. Editor's Note: This Kindred news story is flooding news circuits, due to the scope and significance of its impact. While we reported this on 7/19/24, we will provide occasional variations, keeping it in your awareness. 

Baptist Health settles False Claims allegations for $1.5MBecker's Hospital Review; by Naomi Diaz; 5/7/24Jacksonville, FL-based Baptist Health has agreed to pay $1.5 million to address accusations of breaching the False Claims Act. The health system allegedly prompted its subsidiaries to provide discounts up to 50% or more to patients, aiming to incentivize them to acquire or recommend Baptist Health services covered by federal healthcare programs, according to a May 6 Justice Department news release. ... The Anti-Kickback Statute states that individuals in federal healthcare programs cannot get paid for sending others to receive healthcare for which the government pays. 

2023’s Most Impactful Hospice Regulatory MovesHospice NewsDecember 12, 2023Program integrity issues that have heated up in the hospice space during the past five years reached a boiling point in 2023. Hospice providers have seen an array of increased regulatory oversight in 2023. That momentum has been fueled by two main concerns among regulators—risks of patient safety and evidence of malfeasance in the space. Hospice News sat down with providers, advocacy groups, legal experts and other stakeholders to uncover the most significant hospice regulatory trends from this year and their anticipated impacts heading into 2024 and beyond. ...Editor's Note: Quoted in the article, Jason Wallace, partner in health care, Barnes & Thornburg LLP; Ben Marcantonio, COO and interim CEO, NHPCO; Carrie Uebel, senior vice president and chief ethics and compliance officer, Compassus

CMS’ New Transparency Rule Can Help ‘Weed Out a Few Bad Actors’ but Won’t Impact Deals Much, Other Factors at PlaySkilled Nursing NewsDecember 6, 2023Nursing home ownership changes have largely been embraced by the industry and will have little impact on deal activity, with the new transparency rule from the Centers for Medicare & Medicaid Services having very little impact on the sector. Instead, the new rule will force nursing homes to report ownership details during critical junctures like Medicare or Medicaid applications and recertification, according to executive managing director of VIUM Capital, Steven W. Kennedy. And if anything, the new transparency rule will eliminate any bad actors on the real estate and operating side because these might cause them “discomfort,” and that’s certainly better for the industry, he said. “Every industry no matter where you are has some bad actors,” he said. “I think in general, skilled nursing has very few bad apples, but if they’re out there, this can help weed them out.”