The Move to Self-Reporting Continues: Self-Referral Disclosure Protocol

The Center for Medicare and Medicaid Services (CMS) very recently issued proposed Self-Referral Disclosure Protocol (SRDP) forms along with some revisions to the existing regulations. This happened on May 6, 2016 and it was an additional step in the move for providers to self-report potential or actual violations of the Stark Law. Part of the revisions to the regulations came as a result of the final overpayment rule issued earlier this year on February 11, 2016 (60 Day Rule). CMS expects that the SRDP forms will facilitate faster review of a self-disclosure and make it easier for providers to report potential violations.

The SRDP was established as a result of the Affordable Care Act and is another tool for providers in the effort to resolve Stark related compliance issues. One of the problems with the SRDP is the time that it has taken for self-disclosures to work their way through the system. Some self-disclosures have yet to be resolved and were initially made years and years ago. Essentially, a snail’s pace!

It can be beneficial for providers to be proactive and report violations of the Stark Law using the SRDP. When a provider self-reports an actual or potential violation using the SRDP, CMS considers a reduction in any penalties that may be associated with such violation.

The proposed SRDP forms are an attempt to streamline the somewhat difficult and complicated process. The proposed forms include the following: (1) the SRDP Disclosure Form; (2) the Physician Information Form; (3) the Financial Analysis Worksheet; and (4) the Certification. The forms require specific and detailed information as to the potential violation, including a very detailed financial analysis that includes a 6-year lookback which mirrors the 60 Day Rule lookback.

Providers should also try to avoid having to use the SRDP by taking proactive measures to decrease their risk of a Stark Law violation, including:

• Document all compensation relationships in a contract
• Keep up to date and highly detailed records relating to financial and compensation relationships
• Develop and maintain a Stark Law compliance policy
• Educate staff as to proper referrals and importance of compliance

If a provider is aware of a potential or actual violation of the Stark Law, the provider should consult an experienced health law attorney to consult and confirm whether an actual or potential violation of the Stark Law has occurred and whether a disclosure using the SRDP forms is the appropriate action.

Florida Phosphate Mining In Sovereignty Lands

Since the turn of the twentieth century, the phosphate industry purchased large tracts of land in west central Florida, including the upper Peace River watershed. Florida’s phosphate industry is mining in the Peace River basin, which also include “sovereignty lands”. Florida’s state agencies charged with “permitting” the phosphate industry to strip mine in the Peace River region may be doing so illegally based on the Public Trust Doctrine (3). Sovereignty lands are expressly public in Florida and cannot be altered in any way that disrupts natural processes.

Much of west central Florida landscape consists of lowlands and marshlands. Florida’s highest court historically rules against claims of “swamp deeds” and claims of “overflow lands” in the Peace River watershed because the Peace River is defined as a “navigable waterway.” The argument by Florida’s Supreme Court against swamp deeds and overflow lands is based on The Public Trust Doctrine of Florida. The Court refers to the Public Trust Doctrine in cases including marshlands, lowlands, and flood lands as well.

The Court offers “examples of sovereignty lands”. They can be shallow vegetated shores that are submerged during the rainy season and are lower than the high water boundary surrounding all water bodies in question (lakes, rivers) and are considered “sovereignty lands” by definition based on The Public Trust Doctrine. The Court’s rulings also reflect the riparian lands on the farthest reaches of the navigable waterway. The Court explained areas not always submerged on the outer edges of the waterway were still riparian in nature and sovereignty lands in fact because they lie below the high water marks of the water body in question. In this case, the water body in question is the Peace River and watershed.

In the cases heard by the Florida Supreme Court concerning sovereignty lands; the Court rejects all claims of deeds to properties on related navigable waterways and riparian lands or “sovereign lands.” The Court rejects these property deeds when the agencies involved in selling the land have no right to “convey sovereignty lands”, based on The Public Trust Doctrine, a constitutional doctrine. Meaning large tracts of land sold to the phosphate industry may not be legal to sell because “these” large tracts of land in west central Florida are “sovereignty lands” based on the Peace River watershed and The Public Trust Doctrine.

The definition of sovereignty lands are those lands beneath navigable water bodies in question. Ownership of sovereignty lands is not based on a legal description, but on the nature of the water body in question. Navigable waterways are defined by the water body’s natural characteristics, not by any record of deed or tittle all of which are discussed in The Public Trust Doctrine. Florida’s navigable waterways are clearly established by the Public Trust Doctrine and Florida’s Supreme Court rulings on the subject.

The Peace River watershed is known to be a public navigable “water body” in west central Florida. In areas where the landscape is flat, much of these water bodies do not have a permanent location marked on the ground for high and low watermarks because the watermarks are ambulatory in nature. Historically, they shift gradually, responding to natural processes like erosion or accretion (build up). In cases where the high or low water marks are difficult to ascertain, due to natural causes, the Florida Supreme Court ruled this type of landscape as riparian (public) in nature or sovereignty lands.

The mighty phosphate dragline is the culprit, severely altering or removing navigable waterways and sovereignty lands in west central Florida strip mining operations. Operators are instructed by operations’ managers to remove all in their path to reach the valuable phosphate ore just beneath the “sovereignty lands” and “navigable” water bodies.

Many large tracts of land sold to the phosphate industry in west-central Florida hold navigable waterways and sovereignty lands. This is no secret; all of west central Florida mining operations can be seen from Google© Maps. However, the property may have been conveyed illegally. The Peace River watershed covers almost 2500 square miles. The Upper Peace River watershed encompasses Bartow, Mulberry, and, Pinecrest, FL phosphate facilities. (2) The phosphate facilities in Bartow and Mulberry are two of the largest strip mining operations in the United States.

It is very probable Florida’s phosphate industry has a negative (1) impact on the Peace River watershed because production facilities are located within the boundaries of the Peace River watershed. Historically, the facilities in Mulberry and Bartow cause severe environmental impacts based on billions of gallons of highly toxic waste by-product “releases” over time from each facility.

It may be “impossible” for Florida’s phosphate industry “not” to have a severe negative impact on the Peace River watershed. The particular points mentioned against the phosphate industry are controversial if not unknowingly illegal based on the Public Trust Doctrine and “sovereignty lands” doctrine. However, ignorance is no excuse for breaking laws.

Fire Exit Signs Used in Legal Offices

Fire exit signs are a necessity nowadays. It is not necessary that only a hospital or a school or any profit-making organization should only have these safety signs put up instead putting up of these signs should be made mandatory by law in order to ensure the maximum safety of the people.

Even all the legal offices should put up these signs. Firstly, due to the safety reasons and another reason to set an example to all the other organizations that they should also put up the safety signs just like the legal offices has put up ensuring people’s safety.

Any accident or the fire breakout will not take place with a prior invitation. Therefore, taking all the precautionary actions beforehand by putting up the fire safety signs is always advisable. There should be proper fire safety management plans in every building as it would result in maximum security and less danger.

Importance of the safety signs

The presence of these safety signs in all the legal offices is extremely very important and also ensures a sense of responsibility in the mind of the owners and the management committee. It would ensure the safety of the people.

These signs would help in showing different pathways leading to the exit of the building. These fire escapes are the shortest ways out of the building. This way a lot of people can save their lives and the process of evacuating the building and putting out the fire becomes easier and faster.

The presence of these fire safety signs would serve as an example for the other institutions and organizations to follow the same. Following all the legal offices the other offices and other places would also put up these signs in their buildings ensuring maximum safety and minimum damage to life and property.

These safety signs, will definitely help if it is placed in these offices, even if there are no fire incidents, these signs will not pose any harm but the absence of these signs definitely will be a major problem.

In the absence of these signs, people would not know which path to take as everyone is not aware of every nook and corner of the building. So, the directions on these signs can guide people out of the place.