Health Care Compliance Matters

A Complimentary Newsletter From:

Law Offices Of David S. Barmak, LLC

Managing Risk for Long Term Care and Health Care Providers

Volume 13, Issue 11                          ADVERTISEMENT                                               NOVEMBER 2012

In This Issue
"Obamacare is the Law of the Land"
Terminating an Employee: Workers' Compensation and Modified Light-Duty

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David
David Barmak, Esq.
Matthew Streger
Matthew Streger, Esq.
Brandon

Brandon Goldberg, Esq.

 
Jennifer Cohen

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"Obamacare is the Law of the Land"

Republican Speaker of the House John Boehner's admission makes it clear that the reelection of President Barack Obama has ensured the longevity of Obamacare. The President defeated Governor Mitt Romney earlier this month, winning 332 Electoral College votes to Governor Romney's 206. With Obamacare now enroute to full implementation over the next few years, it is important to understand the implications for health care providers.

 

In particular, the March 2013 deadline for implementation of a fully functional compliance program is now a hard deadline. Not only must policies and procedures be in place, but it must be provable that the system is being used effectively. This means that there must be extensive staff trainings on how to use the program to prevent fraud, waste, and abuse. Such programs generally take several months to a year to set up, and therefore providers must begin instituting a program as soon as possible.

 

New Jersey Governor Chris Christie may yet attempt to prevent certain parts of Obamacare from coming into effect in New Jersey. However, the compliance program deadline is not among the parts of the law that he can block. The federal Department of Health and Human Services will be expecting and checking for implementation.

 

Proper implementation occurs in several steps. First, any current policies and procedures must be reviewed to determine their level of compliance with state and federal standards. Then, they must be supplemented or replaced to correct any deficiencies. Finally, the administration and general staff must learn and follow the new guidance. This last step must be monitored continuously on an ongoing basis.

 

If you have any questions regarding implementing and maintaining a compliance program, please contact Brandon Goldberg, Esq. at 609-454-5351 or bgoldberg@barmak.com.

 

Terminating an Employee: Workers' Compensation and Modified Light-Duty

Oftentimes, an employer may feel that it is placed between the proverbial "rock and a hard place" with regard to certain employment concerns. Under New Jersey law, an employer is prohibited from firing an employee solely because the employee filed a claim for workers' compensation. Consider the following scenario:

 

Arthur, employed by a skilled nursing facility (SNF) as a certified nursing assistant, injures his back while working. Arthur immediately seeks treatment for his injury, with the SNF's doctor diagnosing him as having suffered a back sprain rendering it impossible for him to continue working in his present capacity. Arthur thereafter files for, and receives, workers' compensation. The physician, however, makes a note of the fact that Arthur, while unable to carry out his former duties, is still capable of carrying out modified light duty. Consequently, pursuant to the doctor's diagnosis, the SNF puts Arthur on modified light duty while collecting workers' compensation.

 

A few weeks into his modified duty, however, Arthur begins to miss work without providing any excuses for his absences. Calls to Arthur's phone go unanswered and unreturned. In the space of just a few months, Arthur misses eleven days of work and is written up by the administration for unexplained and unsanctioned call-outs. The director of nursing is now faced with a dilemma: can he or she fire Arthur for excessive absenteeism notwithstanding the fact that he was on light-duty, or will that be deemed a "retaliatory discharge," or punishment for filing a workers' compensation claim, and thus render the SNF liable under New Jersey law?

 

Fortunately for New Jersey SNFs, New Jersey courts have already addressed this issue. Courts have held that an employer will be protected should it have a neutral policy for absences which does not specifically target any specific employee. Merely pointing to the fact that an employee collected workers' compensation and was subsequently fired is inadequate to prove a case of retaliatory discharge. Thus, in this case, the SNF will not be in violation of the law prohibiting retaliatory discharge should it choose to fire Arthur. The fact that Arthur was put on modified light-duty and was receiving workers' compensation is irrelevant as long as the SNF did not specifically target Arthur. In sum, as long as a business has clear and unambiguous policies regarding call-outs and unexcused absenteeism it will not be subject to liability for terminating employees that violate those policies, even if those employees are receiving workers' compensation and are on modified light duty.  

Law Offices Of David S. Barmak, LLC

Our firm is dedicated to helping health care providers, such as skilled nursing facilities and other health care providers, and the suppliers to those firms, manage risk through comprehensive compliance programs that focus on early intervention through on-site training, communication, policy & procedure review, monitoring and consultation. The program includes on site auditing and training in the areas of, but not limited to, fraud & abuse, HIPAA privacy & HITECH data security, employment, emergency preparedness, workplace violence, clinical documentation, sexual harassment and social networking.

 

The firm's compliance team includes experienced compliance attorneys, nurses, physical therapists, pharmacy consultants, information technology specialists, nurse practictioners, administrators, orthodists & prosthetists and EMS professionals, who are available to assist clients with pre and post Department of Health (DOH) survey procedures, respond to DOH questions, prepare for re-inspections, minimize risks for deficiencies, offer support to Directors of Nursing regarding correct care plans, incident reports and therapy notes, review Medicare billing and audit PPS/Medicare/Medicaid insurance documentation.

 

The recipient may, if the newsletter is inaccurate or misleading, report the same to the Committee on Attorney Advertising.

 

This newsletter has been prepared by the Law Offices Of David S. Barmak, LLC for informational purposes only and is not intended to provide legal advice. You should consult an attorney for advice regarding your individual situation. We invite you to contact us. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established.

 

For more information, please contact David S. Barmak, Esq.:

Telephone (609) 454-5351

Fax (609) 454-5361

www.Barmak.com

 
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