LONG-TERM ACUTE CARE HOSPITALS (LTCHs)

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We have a long history of specializing in legal issues affecting long-term acute care hospitals. 

Our Principal, Jason Healy, served as General Counsel to the Acute Long Term Hospital Association (ALTHA) with over 300 member hospitals. In this capacity, Jason advised ALTHA on legislative, rulemaking, and other legal matters affecting its membership. 

We counsel individual and chain LTCHs on virtually every type of legal matter impacting their business, including: legislation, regulation, compliance, reimbursement, litigation, development, transactions and other issues.

• Active involvement in many pieces of federal LTCH legislation over the past 15 years
• Helped shape legislative proposals, achieve consensus with other hospital trade associations, and work with Congressional staff and legislative counsel on LTCH bills that were enacted as part of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA), the American Recovery and Reinvestment Act of 2009 (ARRA), and the Patient Protection and Affordable Care Act of 2010 (PPACA)
• Regularly counsel LTCHs on the impact of statutes on their business, including COVID-19 pandemic relief and site neutral payment

• Prepare written comments to LTCH Medicare payment updates and other rulemakings on behalf of LTCH companies
• Advise LTCHs on Medicare regulations and policies that impact LTCHs, including rules concerning: conditions of participation, hospitals-within-hospitals, satellite facilities, remote locations, provider-based entities, and grandfathering

• Regularly advise LTCHs on average length of stay (ALOS) calculation and compliance matters, coordination with Medicare MAC on ALOS testing
• Assist LTCHs with compliance programs, legal reviews of compliance issues, internal audits, and legally privileged independent audits
• Advise and assist with overpayment and other compliance disclosures to government agencies
• Advise LTCHs on corporate integrity agreement compliance and disclosures 

• Regularly counsel LTCHs on the LTCH prospective payment system (LTCH PPS) and its payment adjustments, including site neutral payment, patient criteria, high cost outliers, and short stay outliers
• Advise LTCHs on outlier reconciliation
• Assist LTCHs in obtaining written guidance from CMS and its components on regulatory issues
• Work with LTCHs on proposed cost report adjustments and other reimbursement disputes to avoid the need for appeal

• Federal and state court challenges to LTCH regulations and reimbursement determinations
• Represent LTCHs in administrative appeals of Medicare reimbursement disputes on cost report determinations before the Provider Reimbursement Appeals Board and CMS Administrator, and on claims determinations before Administrative Law Judges and the Departmental Appeals Board
• Represent LTCHs in appeals challenging MAC medical necessity audits
• Represent LTCHs in Medicare decertification appeals to the Departmental Appeals Board

• Negotiate lease agreements and ancillary services agreements for new LTCH hospitals-within-hospitals and satellite facilities
• Advise LTCHs on new buildings, bed increases, relocations, satellite facilities, remote locations, certificates of need, and provider-based status
• Assist LTCHs with obtaining advance determinations from CMS on regulatory issues and exceptions

• Perform regulatory due diligence for buyers and sellers in LTCH transactions with an emphasis on LTCH-specific regulatory and compliance issues
• Provide written opinions of relative risk associated with regulatory issues identified for target companies
• Advise and assist LTCHs with government approvals and notifications in connection with licensure, certification, and accreditation requirements

For LTCHs that are firm clients or not clients yet, we also provide more comprehensive, ongoing guidance on LTCH regulatory, legislative and judicial developments in the law and federal programs for an annual fee (for more information on this service, please click below)  

* Long-term acute care hospitals may be referred to using the acronyms LTCHs, LTACs, or LTACHs.