The Health Lawyer - October 2019

Health

Goodbye, RUGS! Hello, PDPM: Fundamental Changes to SNF Medicare Payment

By Mark A. Johnson, Esq. Hooper Lundy & Bookman, PC, San Diego, CA; Matthew I. Lahana, Esq. Hooper Lundy & Bookman, PC, San Diego, CA; Michael Lesnick, Axiom Healthcare Group, Roseville, CA

On October 1, 2019, Medicare payments to Skilled Nursing Facilities (SNFs) began to be reimbursed under a new payment methodology called the Patient Driven Payment Model (PDPM).1 This is the first truly significant change to SNF Medicare payment methodology in more than 20 years.

Mental Health

The Supreme Court Limits Agency Deference: Implications of Kisor v. Wilkie

By Jessica L. Gustafson, Esq. and Adrienne Dresevic, Esq., The Health Law Partners P.C., Farmington Hills, MI

On June 26, 2019, in a splintered 5-4 decision, the United States Supreme Court issued its decision in the case of Kisor v. Wilkie. At issue was the fate of Auer deference (sometimes referred to as Seminole Rock deference), which is the legal doctrine expressing that a court will defer to an agency’s reasonable interpretation of its own genuinely ambiguous regulation.

Health

Frameworks for Evaluating Life Care Plans

By Penelope Caragonne, Ph.D., CLCP, Caragonne and Associates, Inc., Laredo, TX; Keith Sofka, ATP (Ret.), Caragonne and Associates, Inc., Laredo, TX; Wendie Howland, MN RN-BC CRRN CCM CNLCP LNCC, Howland Health Consulting, Inc., Pocasset, MA

A life care plan, a growing factor in litigation, is an overall service or care plan that provides for goods and services to achieve best outcomes over the life expectancy of a person with a disability resulting from catastrophic injury.

Health

Health Law Section Announces 2018-2019 Top 10 Law Firms

Our members are the lifeblood of the ABA Health Law Section. Our members are among the most experienced and dedicated health law practitioners in the country, serving a wide array of roles and commonly united in pursuit of professional excellence.