Leadership Changes at CMS

CMS has made three new appointments to their quality division.

Lee Fleisher, MD is now the Chief Medical Officer for the Centers for Medicare and Medicaid Services (CMS). He will also serve as Director of the Center for Clinical Standards and Quality, which is the focal point for all quality, clinical, medical science issues, survey and certification, and policies for CMS programs.

Dr. Fleisher leaves his position as chair of the Department of Anesthesiology and Critical Care at Penn Medicine but will maintain a clinical role at Penn Medicine and as a member of their faculty while serving in his federal position. Dr. Lee will begin his transition into his new role in July.

CMS promoted Michelle Schreiber, MD, to deputy director for quality and value at the Center for Clinical Standards and Quality (CCSQ).  In her past position, Dr. Schreiber was Director, Quality Measurement & Value Based Incentives Group (QMVIG), at CMS. Her responsibilities included Group director for multiple national quality and value based programs such as Hospital Value Based Purchasing, Hospital Stars, Promoting Interoperability (Meaningful Use), MACRA, Post-acute care quality programs, and others.

Karen Tritz was promoted to survey and operations group director at CMS. Ms. Tritz is director of CCSQ’s Quality Safety and Oversight Group Division of Continuing and Acute Care Providers. According to CMS, she has experience leading efforts to develop new guidelines, improving survey and enforcement processes, and strengthening oversight of accrediting organizations.

At the end of last year, CCSQ expanded its scope and staff to include all of the regional employees who conduct the quality and safety surveys of healthcare facilities and oversee the enforcement of the quality and safety standards.” Ms. Verma wrote in explaining the changes. “This integration made CCSQ the agency’s single point of contact for quality and safety work. This new scope led to the need for additional roles to complement the existing senior leadership structure.”

Visiting Nurse Service of New York (VNSNY)

The False Claims Act lawsuit brought against the Visiting Nurse Service of New York (VNSNY) has been settled for $57 million. VNSNY is the largest not-for-profit home health care agency in the country, serving roughly 150,000 patients a year in New York, most of whom are elderly and/or disabled. A copy of the settlement can be found here.

The whistleblower who filed this action, Edward Lacey, was an executive at VNSNY for 16 years.  In his complaint, Mr. Lacey alleged that VNSNY failed to provide its patients with all the critical nursing and therapy visits and services their doctors prescribed under the patient Plans of Care.  He contended that by failing to provide this care, VNSNY endangered the welfare of tens of thousands of its patients while maximizing the company’s Medicare and Medicaid reimbursement.

This is the first reported False Claims Act settlement involving allegations of a home health agency failing to follow patient Plans of Care.  It also is the largest non-kickback False Claims Act settlement ever against a home health care company and the second-largest settlement of any home health care fraud case.

Orlando Health and LHC Group Partner

LHC Group (NASDAQ: LHCG) and Orlando Health have announced signing a definitive agreement to form a new joint venture to enhance home health and home and community-based services (HCBS) in the state of Florida. The joint venture will include six total locations – three current Orlando Health providers and three current LHC Group providers in Orlando, Clermont, Kissimmee, and Altamonte Springs.

It is anticipated that the joint venture agreement will be finalized on August 1, subject to customary closing conditions, at which time LHC Group will purchase majority ownership and assume management responsibility. LHC Group expects incremental annualized revenue from this joint venture of approximately $3.5 million and that it will not materially affect its 2020 diluted earnings per share.

Orlando Health is a not-for-profit healthcare network based in Orlando. The system spans nine Florida counties with nearly 450 locations that include 13 wholly-owned or affiliated hospitals and emergency departments; rehabilitation services, cancer centers, heart institutes, imaging, and laboratory services, wound care centers, more than 300 physician offices for adults and pediatrics, and 11 urgent care centers in partnership with CareSpot Urgent Care.

LHC Group is a leading national provider of in-home healthcare services and the joint venture partner of choice for 350 hospitals across the United States.

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