News & Insights


October 21, 2019

Health Headlines – October 21, 2019

CMS Announces Enhanced Oversight of Nursing Home Inspections by Strengthening the State Performance Standards System – On October 17, 2019, CMS published the fiscal year (FY) 2020 State Performance Standards System (SPSS) Guidance with a focus on monitoring and improving each of the State Survey Agencies’ (SSAs) performance in nursing home inspections. The CMS memorandum can be found here. CMS’s modifications are intended to improve the care provided in nursing homes and respond to concerns regarding inconsistent and untimely inspections. The updated guidelines are intended to allow CMS to “more rigorously and rapidly analyze SSA performance to ensure inspections are timely and accurate.”  

Specific changes to the SPSS include:

  • Increased monitoring metrics to ensure SSAs are conducting surveys in a timely manner;
  • New “State Performance Indicators” to identify potential issues with respect to SSA performance;
  • Formally measuring the timeliness and accuracy of SSA notifications of cases in which the health and safety of patients are in immediate danger;
  • Increased system flexibility to include state-specific measures if CMS intends to target resources to poor performing SSAs; and
  • Better access for SSAs to centralized CMS data to avoid redundant or duplicative data reporting and unnecessary administrative burdens on SSAs.

CMS’s SPSS revisions are part of CMS’s five-part approach to ensuring safety and quality in nursing homes. This five-part approach includes the following pillars: Strengthen Oversight, Enhance Enforcement, Increase Transparency, Improve Quality, and Put Patients Over Paperwork. CMS’s October 17, 2019 press release regarding the plan can be found here.

Reporter, Kathryn Han, Los Angeles, +1 213 443 4336,

Also in the News

Save the Date for King & Spalding Webinars:

Recalculating:  Are the Major Stark, Anti-Kickback and CMP Proposed Rule Changes Taking Us in a New Direction? 

CMS and OIG recently proposed the most significant changes to the Stark Law rules, the Anti-Kickback Statute (AKS) safe harbors and the Beneficiary Inducements CMP regulations that the agencies have offered in recent years.  The proposed rules address value-based arrangements, introduce major changes to other key Stark Law concepts and definitions, address the donation of cybersecurity technology and services, and create flexibility to provide patient incentives in value-based arrangements and with respect to telehealth.  Click here to read King & Spalding’s Client Alert highlighting the key proposals.

Thursday, November 7, 2019
1:00 P.M. – 2:30 P.M. ET

Wednesday, November 20, 2019
1:00 P.M. – 2:30 P.M. ET

We are hosting a two-part webinar series to discuss these proposals in greater detail, described below.  We will cover the opportunities raised by these proposals, as well as how they may impact enterprise risk and future enforcement actions.  Our goal is to stimulate thinking about the submission to CMS and OIG of comments on these proposed rules, which are due on December 31, 2019. 

  • In Part One, we will discuss proposed changes other than those relating to value-based arrangements and patient incentives.  The topics will include the proposed changes to fundamental Stark Law concepts such as taking into account the volume or value of referrals or other business generated, fair market value, commercial reasonableness and the definition of indirect compensation arrangements.  We also will address proposed changes to the writing requirements, proposed changes to several commonly used compensation exceptions and proposals related to cybersecurity technology and related services. 
  • In Part Two, we will discuss proposals related to value-based arrangements and patient incentives.  This will include the newly proposed AKS safe harbors and Stark Law exception for value-based arrangements, modifications to existing AKS safe harbors and Stark Law exceptions to address value-based arrangements, newly proposed AKS safe harbors for patient incentives, revisions to the local transportation safe harbor and a proposed telehealth exception to the Beneficiary Inducements CMP.

You do not have to be a client to attend, and there is no charge.  Registration is not yet available.

King & Spalding Will Host 12th Annual Pharmaceutical University in Philadelphia – On November 12, 2019, King & Spalding will host more than 300 guests at its annual Pharmaceutical University at the Westin in Philadelphia.  For more than a decade, attendees of Pharma U have raved about the breadth and quality of the programming and have embraced the many opportunities to network with hundreds of attendees from the world’s most sophisticated pharmaceutical and biotechnology companies.

This year’s curriculum will include four concurrent tracks and more than 20 different interactive presentations from which to choose.  Lawyers from across the firm will deliver courses on cutting-edge issues critical to pharmaceutical and biotechnology lawyers, executives, and managers.  This year’s sessions will address regulatory, enforcement, litigation, commercial, corporate, intellectual property, international trade, and political issues, among many other cutting-edge issues. 

Click here to register.  Registration is $99 per person until Friday, October 18.  Space is limited.  For more information about accommodations, click here.