10 unchanged sentences
Department of Justice Civil Investigative Demand - On May 31, 2018, we received a Civil Investigative Demand (CID) from the U.S.
−Removed: Department of Justice stating that it is investigating to determine whether there has been a violation of the False Claims Act and/or the Anti-Kickback Statute with respect to the relationships between certain of our independently operated skilled nursing facilities and persons who serve or have served as medical directors, advisory board participants or other potential referral sources.
−Removed: The CID covered the period from October 3, 2013 to the present, and was limited in scope to ten of our Southern California independent operating entities.
−Removed: In October 2018, the Department of Justice made an additional request for information covering the period of January 1, 2011 to the present, relating to the same topic.
+Added: Department of Justice stating that it was investigating to determine whether there has been a violation of the False Claims Act and/or the Anti-Kickback Statute with respect to the relationships between certain of our independently operated skilled nursing facilities and persons who serve or have served as medical directors, advisory board participants or other potential referral sources.
+Added: The CID covered the period from October 3, 2013 through 2018, and was limited in scope to ten of our Southern California independent operating entities.
+Added: In October 2018, the Department of Justice made an additional request for information covering the period of January 1, 2011 through 2018, relating to the same topic.
As a general matter, our independent operating entities maintain policies and procedures to promote compliance with the False Claims Act, the Anti-Kickback Statute, and other applicable regulatory requirements.
We have fully cooperated with the U.S.
−Removed: Department of Justice to promptly respond to the requests for information, and have recently been advised that the U.S.
−Removed: Department of Justice has declined to intervene in any subsequent action based on or related to the subject matter of this investigation.
−Removed: Litigation — We are party to various legal actions and administrative proceedings, and are subject to various claims arising in the ordinary course of business, including claims that services provided to patients by our independent operating entities have resulted in injury or death and claims related to employment and commercial matters.
+Added: Department of Justice and promptly responded to their requests for information, and have recently been advised that the U.S.
+Added: Department of Justice has declined to intervene in any subsequent action filed by a relator in connection with the subject matter of this investigation.
+Added: Litigation — We and our independent operating entities are party to various legal actions and administrative proceedings, and are subject to various claims arising in the ordinary course of business, including claims that services provided to patients by our independent operating entities have resulted in injury or death, and claims related to employment and commercial matters.
Although we intend to vigorously defend against these claims, there can be no assurance that the outcomes of these matters will not have a material adverse effect on operational results and financial condition.
4 unchanged sentences
Such regulatory scrutiny often includes inquiries, investigations, examinations, audits, site visits and surveys, some of which are non-routine.
−Removed: In addition to being subject to direct regulatory oversight of State and Federal regulatory agencies, the skilled nursing and post-acute care industry is also subject to regulatory requirements which could subject us to civil, administrative or criminal fines, penalties or restitutionary relief, and reimbursement;
+Added: In addition to being subject to direct regulatory oversight from State and Federal regulatory agencies, the skilled nursing and post-acute care industry is also subject to regulatory requirements which could subject us to civil, administrative or criminal fines, penalties or restitutionary relief, and reimbursement;
authorities could also seek the suspension or exclusion of the provider or individual from participation in their programs.
2 unchanged sentences
Additionally, the U.S.
−Removed: House of Representatives Select Subcommittee on the Coronavirus Crisis has launched an investigation into the coronavirus crisis in nursing homes.
+Added: House of Representatives Select Subcommittee on the Coronavirus Crisis has launched a nation-wide investigation into the coronavirus crisis in nursing homes.
In June 2020, the Company received a document request from the House Select Subcommittee.
−Removed: The Company is cooperating with this inquiry;
−Removed: however, it is not possible to predict the ultimate outcome of any such investigation or what other investigations or regulatory responses may result from the investigation and could have a material adverse effect on our reputation, business, financial condition and results of operations
+Added: The Company is cooperating in responding to this inquiry.
+Added: However, it is not possible to predict the ultimate outcome of any such investigation, or whether and what other investigations or regulatory responses may result from the investigation and could have a material adverse effect on our reputation, business, financial condition and results of operations.
In addition to the potential lawsuits and claims described above, we are also subject to potential lawsuits under the Federal False Claims Act and comparable state laws alleging submission of fraudulent claims for services to any healthcare program (such as Medicare) or payor.
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For example, and despite the decision of the U.S.
−Removed: Department of Justice to decline participation in litigation based on the subject matter of its previously issued Civil Investigative Demand, the qui tam relator may continue on with the lawsuit and pursue claims that one or more of the Company' independent operating entities have allegedly violated the False Claims Act and/or the Anti-Kickback Statute.
+Added: Department of Justice to decline participation in litigation based on the subject matter of its previously issued Civil Investigative Demand, the qui tam relator may continue on with the lawsuit and pursue claims that one or more of the Company's independent operating entities have allegedly violated the False Claims Act and/or the Anti-Kickback Statute.
In addition to the Federal False Claims Act, some states, including California, Arizona and Texas, have enacted similar whistleblower and false claims laws and regulations.
−Removed: In addition, the Deficit Reduction Act of 2005 created incentives for states to enact anti-fraud legislation modeled on the Federal False Claims Act.
+Added: Further, the Deficit Reduction Act of 2005 created incentives for states to enact anti-fraud legislation modeled on the Federal False Claims Act.
As such, we could face increased scrutiny, potential liability, and legal expenses and costs based on claims under state false claims acts in markets in which our independent operating subsidiaries do business.
19 unchanged sentences
Medicare Revenue Recoupments — We and our independent operating subsidiaries are subject to regulatory reviews relating to the provision of Medicare services, billings and potential overpayments resulting from reviews conducted via RAC, PSC and MIC (collectively referred to as Reviews).
−Removed: CMS has suspended all Targeted Probe and Educate program activity due to the State of Emergency.
−Removed: Accordingly, as of June 30, 2020, none of our independent operating subsidiaries had Reviews scheduled, on appeal, or are in a dispute resolution process, both pre- and post-payment.
−Removed: Once the suspension period has been lifted our previously in-progress reviews could begin again.
−Removed: We anticipate that these Reviews will reconvene and could increase in frequency in the future.
+Added: For several months during the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) suspended its Targeted Probe and Educate (TPE) program.
+Added: In July 2020, CMS announced that TPE program activity would resume in August 2020.
+Added: As of September 30, 2020, none of our independent operating subsidiaries had Reviews scheduled, on appeal, or in a dispute resolution process.
+Added: We anticipate that these Reviews could increase in frequency in the future.
+Added: If an operation fails a Review and/or subsequent Reviews, the operation could then be subject to extended review or an extrapolation of the identified error rate to billings in the same time period.
+Added: As of September 30, 2020, our independent operating subsidiaries have responded to the requests and the related claims are currently under review, on appeal or in a dispute resolution process.
Compared sentence by sentence after normalising whitespace, quotation marks, case and digits, so re-formatting and restated figures do not read as changed language. Wording changes appear as one removal and one addition. The current filing and the prior one are authoritative.