CMS showing confidence in managed care plans’ fraud-prevention efforts
By
John Hall
Jun 01, 2015
Medicaid managed care plans would be limited to fraud prevention expenditures of 0.5% of premium revenue when calculating medical loss ratios, signaling high confidence from federal regulators that such...
Senator asks CMS to probe suspected Medicaid Advantage fraud
By
John Hall
Jun 01, 2015
A prominent U.S. senator is asking the Centers for Medicare & Medicaid Services to investigate Medicare Advantage plans that may have inflated their risk scores to receive higher reimbursements.
Government regulators might start policing personal monitoring devices
By
John Hall
May 29, 2015
The government is keeping a watchful eye on personal monitoring devices and may soon regulate them due to privacy concerns and accuracy claims, consumer advocates and tech gurus recently predicted at a...
Nursing home caregivers often MRSA conduits: Study
By
John Hall
May 29, 2015
Nursing home caregivers are often unwittingly conduits that spread an infection that could lead to a potentially lethal flesh-eating disease, according to a new study in a leading infection control journal.
ALFA offers new labor relations toolkit
By
John Hall
May 29, 2015
The Assisted Living Federation of America is offering updated resources to help providers better handle labor relations issues.
Supreme Court whistleblower rulings a mixed blessing for providers
By
John Hall
May 28, 2015
A Supreme Court ruling in a whistleblower suit in Iraq could have far-reaching implications for healthcare providers, legal observers say.
CVS pays $22 million to settle painkiller prescription allegations
By
John Hall
May 28, 2015
While the long-term care industry continues seeking internal solutions to stem drug diversion and over-prescribing of powerful painkillers and opioids, federal and state law enforcement agencies are beginning...
Popular Alzheimer’s drug to remain on the market at least until August
By
John Hall
May 27, 2015
A federal appeals court has temporarily thwarted a drug company’s plan to replace a proven Alzheimer’s drug with a more expensive version.
New CMS Medicaid managed care rule introduced
By
John Hall
May 27, 2015
An ambitious and comprehensive policy-making effort that promises to completely transform and radically overhaul the Medicaid managed care marketplace has passed White House Office of Management and Budget...
Heightened calls to curb painkiller-related hospitalizations and deaths on both sides of the aisle in Congress and the presidential campaign trail may make providers concerned about more restrictions on...