Meg LaPorte

In the federal government’s war on health care fraud and abuse, the strategy of “pay and chase” is history, according to the Centers for Medicare & Medicaid Services. The new front on fraud deploys a more proactive approach that officials say will screen out would-be bilkers and streamline the process so that honest providers can better navigate the system.

A report issued to Congress yesterday by the Centers for Medicare & Medicaid Services sketches out a preliminary framework for implementing a Medicare value-based purchasing program for skilled nursing facilities. Included in the 80-page report is a road map for implementation and eight elements the agency will consider as it designs the program.

Embracing innovation in health care as an opportunity to change things for the better was the main theme of a House hearing, which included a witness panel consisting of representatives from health insurance giant United Health Group as well as three provider groups. But it was Kindred Healthcare Chief Executive Officer Paul Diaz who ended up fielding the majority of questions during the two-hour hearing.

Genesis HealthCare Corp., Kennett Square, Pa., inked a deal yesterday to acquire Sun Healthcare Group for a hefty $273.3 million net of cash and debt acquired. The acquisition puts Sun stock at a price of $8.50 per share—a 43.1 percent premium over the closing sale price of Sun shares on Tuesday, June 19, the companies said in statements.

If you speak to almost any long-term care physician these days you'll likely hear that there are few incentives for physicians to practice in nursing homes. In addition to low pay, nursing home physicians are either stuck with prohibitively expensive insurance premiums or denied access to coverage because most liability carriers have decided that long-term care is no longer within their "risk appetite." Many believe that quality long-term care is jeopardized by the current medical liability crisis.

Bill Thomas, MD, would like to clear up a misconception about his position on nursing facilities: He doesn’t want to eradicate them; he wants to eliminate the traditional, institutional model of care that was adopted by nursing facilities nearly 50 years ago. “I want to abolish the practice of institutionalizing frail, older people,” he says. “The old model of the nursing homes needs to go away and be replaced with new models.”

Although investigations and prosecutions of skilled nursing facilities by federal and state government agencies are on the rise, medical directors can take some immediate steps to minimize liability risks for themselves and their facilities.