Creator: Patrick Connole
Legal Trifecta: Mark Reagan Briefs SNFs on Must-Know Issues
Mark E. Reagan has written three expert articles over the last months for Park Place on legal issues that are important to a provider’s bottom line and operations.
The following are the three previous Park Place columns written by Mark E. Reagan, the top legal expert in the long-term care sector. Each article has a summary and a link, and each addresses a topic of importance to a provider’s operations and bottom line. Enjoy.
A majority of states throughout the nation have received approval from CMS to contract with Medicaid health plans to manage the payment and delivery of most Medicaid services. In many of these states, skilled nursing services are included within the bundle of managed care services administered by health plans. Although some states allow beneficiaries to choose whether to have their skilled nursing services managed by health plans or through state fee-for-service systems, most states require health plan oversight.
This article focuses on the unprecedented power delegated to such plans and what tools, if any, operators can use to protect themselves from threats of termination from these plans.
For many post-acute and long-term care operators, the COVID-19 pandemic continues to live on despite its cessation some three years ago. For some, the lingering elements include lawsuits alleging negligent conduct relating to operator COVID-19. This article will explore recent judicial decisions supporting civil immunity from such legal actions under the Public Readiness and Emergency Preparedness Act (“PREP Act”). The use of the PREP Act is particularly important to the operators in states that had not enacted immunity laws to protect healthcare providers during the pandemic.
Over the last few years, the sector has seen enormous growth in the enrollment in Medicare Advantage and Managed Medicaid programs. This has produced tremendous challenges for operators. This dynamic has also put pressure on communications with residents and families about managed care arrangements and relationships. This article will explore how to leverage the dissemination of objective information to allow for decision-makers to make informed decisions while also avoiding legal risk.
Mark E. Reagan is the managing shareholder of Hooper, Lundy and Bookman, and a regular contributor to Park Place.
Comments or questions? Contact Patrick Connole at pconnole@parkplacelive.com.
