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.
Speakers/Course Author - Elizabeth E. Hogue, Esq.
- Describe the federal Anti-Kickback Statute;
- Identify requirements of the small investment interest safe harbor;
- Describe the Special Fraud Alert on Contractual Joint Ventures; and
- Identify limits on joint ventures.
By completing/passing this course, you will attain the certificate HCAF Course Certificate
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