- October 15, 2024
- FIRM NEWS
Garfunkel Wild’s Colleen R. Pierson was quoted in a Law360 article highlighting the Biden administration's efforts seeking a broad, potentially problematic trove of information from nursing homes.
Biography
Colleen R. Pierson joined Garfunkel Wild, P.C. in 2023. Colleen is a member of the firm's Investigations, Audits, and Regulatory Compliance Practice Group. Colleen’s practice includes representation of skilled nursing facilities, assisted living facilities, physicians and other health care industry-related clients (both for profit and not-for-profit) in the area of health care compliance, with a specific focus on regulatory compliance, fraud, and abuse laws. She has particular expertise assisting clients with matters before the New York State Department of Health, the New York State Department of Education, and other state agencies. Colleen also serves as Assistant Town Attorney to the Town of Glenville. Colleen brings over a decade of New York State government experience, having worked in several roles for the New York State Legislature and the New York State Division of Budget.
Prior to joining the firm, Colleen was with a Capital District law firm in their Health Law Group where she worked on a wide range of state and federal civil litigations, including Article 78 actions, transactional work, and other advisory services on behalf of skilled nursing facilities, physicians, and assisted living facilities. During her law school career, Colleen continued her work at the New York State Division of Budget in their Legal and Procurement Unit and participated in externships with the Honorable Mae D’Agostino of the United States District Court for the Northern District of New York and the New York State Attorney General’s Litigation Bureau.
Prior to joining the firm, Colleen was with a Capital District law firm in their Health Law Group where she worked on a wide range of state and federal civil litigations, including Article 78 actions, transactional work, and other advisory services on behalf of skilled nursing facilities, physicians, and assisted living facilities. During her law school career, Colleen continued her work at the New York State Division of Budget in their Legal and Procurement Unit and participated in externships with the Honorable Mae D’Agostino of the United States District Court for the Northern District of New York and the New York State Attorney General’s Litigation Bureau.
News
Insights
Additional speaking & writing
Speeches and Events
- September 30, 2024
- ALERTS
The Centers for Medicare and Medicaid Services (CMS) has developed a new patient evaluation tool called Hospice Outcomes Patient Evaluation (HOPE) that will replace the current tool, Hospice Item Set (HIS). Hospices will be required to use HOPE for all patient admissions after October 1, 2025.
- September 19, 2024
- ALERTS
The U.S. Department of Health and Human Services, Office of Inspector General (the “OIG”) posted an unfavorable Advisory Opinion (24-08) prohibiting a Corporation offering Medicare Advantage (“MA”), MA-Prescription Drug (“PD”), and MA/MA-PD Employer Group Waiver Plans (“EGWPs”) from sharing a percentage of its savings with its covered groups via a gainshare payment (“Payment”).
- August 26, 2024
- ALERTS
On August 7, 2024, the New York State Department of Health’s (DOH) proposed regulations for a new, unified licensure process for Program of All-Inclusive Care for the Elderly (PACE) organizations were published in the New York State Register. The proposed regulations implement New York Public Health Law (PHL) Article 29-EE, which was enacted in 2022. The proposed regulations, if adopted, will impact PACE organizations that are currently operating, as well as entities with pending and future PACE applications.
- July 17, 2024
- ALERTS
On July 16, 2024, the New York State Department of Health (DOH) announced in a letter to nursing home administrators that nursing homes across the state will receive an additional 1% increase in their Medicaid rate after receiving Centers for Medicare and Medicaid Service (CMS) approval.
- July 2, 2024
- ALERTS
Garfunkel Wild’s 2023-24 Legislative Session Update newsletter will keep you up to date on relevant legislation introduced in New York State, particularly involving hospitals and long term care facilities.
- July 1, 2024
- ALERTS
The OIG's trend of ensuring access to care in compelling circumstances continued with a recent opinion allowing a pharmaceutical affiliate to refund, waive, or delay payment for a drug treating a rare, fatal pediatric immunodeficiency disorder.
- June 4, 2024
- ALERTS
The Court of Appeals recently upheld New York State’s elimination of residual equity, a capital cost component of Medicaid rates afforded to for-profit nursing homes with older facilities (the “Elimination”).
- May 24, 2024
- ALERTS
On May 23, 2024, the AHCA filed a lawsuit challenging the CMS's Federal Minimum Staffing Mandate, calling it "irrational" and "unattainable" due to staffing shortages and lack of statutory authority.
- April 18, 2024
- ALERTS
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (24-02) permitting a non-profit organization (Non-Profit) to provide financial support to eligible patients with specific rare diseases through assistance programs (Programs) it operates.
- March 21, 2024
- EVENTS
This session will explain the medical equipment waiver process and provide clarity on what steps Adult Care Facilities (ACFs) should take to get their waivers approved and remain compliant with State regulations.
- March 7, 2024
- EVENTS
This session will provide clarity on what steps ACFs should take to remain compliant with State regulations.
- March 4, 2024
- ALERTS
Nursing homes being cited for Life Safety Code (LSC) deficiencies by the New York State Department of Health (DOH) are on the rise. The difficulty achieving substantial compliance or obtaining a waiver places nursing homes at risk for termination from Medicare and Medicaid, denial of payments, and monetary penalties.
- January 17, 2024
- ALERTS
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (23-15) permitting a consulting company’s (Consultant) proposal to offer gift cards to its current physician practice customers for referring potential new physician practice customers to Consultant. Notably, OIG determined that the proposed arrangement did not implicate the Anti-Kickback Statute (AKS).
- January 17, 2024
- ALERTS
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) recently designated oversight of managed care as a “priority area”, and developed a coordinated strategic plan (the Plan) to better align its audits, evaluations, investigations, and enforcement of managed care.
- December 21, 2023
- ALERTS
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted two favorable Advisory Opinions (23-09 and 23-10) to allow a licensed offeror of Medicare Supplemental Health Insurance (Medigap Plan) policies and a preferred health organization (PHO) (collectively, “the requestors”) to incentivize Medigap Plan policyholders to seek inpatient care from a hospital within the PHO’s network. Notably, OIG issued these favorable opinions even though the proposed incentives implicated the Anti-Kickback Statute (AKS) and the Beneficiary Inducement Civil Money Penalty (CMP), and there was no applicable exception or safe harbor.
- December 5, 2023
- ALERTS
On November 17, 2023, the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) published a final rule (“Final Rule”) imposing new ownership disclosure requirements on Medicare skilled nursing facilities and Medicaid nursing facilities (“nursing homes”). Due to concerns over the quality of patient care in facilities owned by certain types of nursing facility owners, including private equity companies and real estate investment trusts, CMS believes these new disclosure requirements will allow them to monitor and hold nursing homes accountable.
- November 21, 2023
- ALERTS
The U.S. Court of Appeals for the Second Circuit decision held that while nursing homes have a general obligation to adequately care for their residents, there is no specific requirement that nursing homes use Medicaid or Medicare reimbursement payments in a certain way because such payments are reimbursements for services already provided to residents, and do not contain “forward-looking conditions” on how the funds must be used.
- November 17, 2023
- ALERTS
On November 15, 2023, the DOH adopted new regulatory requirements for adult ACFs in an effort to expand resident rights in conformance with the CMS’s HCBS rule final rule. ACFs across the State are now required to allow residents to have visitors at any time, giving them unrestricted access to common areas.
- November 7, 2023
- ALERTS
On November 6, 2023, the OIG released its General Compliance Program Guidance, the first in a series of new, non-binding reference guides designed to share information with health care compliance professionals and other health care industry stakeholders
- October 19, 2023
- ALERTS
In Advisory Opinion No. 23-06, the U.S. Department of Health and Human Services’ Office of the Inspector General (OIG) declined to approve a proposed arrangement in which an anatomic pathology laboratory operator would purchase the technical component of anatomic pathology services from Physician and Non-Physician Laboratories for commercial payors.