Judge sees no conflict of interest in hearing case against SNF owner who contributed $40k to her campaign
By
Nov 14, 2016
An Arkansas Supreme Court justice who received campaign funds from a nursing home owner said she has no plans to hand off hearing an appeal in a wrongful death lawsuit against him.
Ask the Legal Expert about… surveyor conduct
By
John Durso
Oct 05, 2015
Surveyors recently were unfair, and rude. They inappropriately threatened my managers with unfounded citations. The next time they come, I want to audiotape or videotape them. Can I legally do this?
CDC releases 2015-2016 flu shot recommendations
By
Aug 11, 2015
Seniors should be vaccinated for the flu before December, according to new vaccination recommendations from the Centers for Disease Control and Prevention.
CMS begins new round of recovery audit contracts, says improvements will be seen
By
Tim Mullaney
Jan 06, 2015
Connolly LLC will be the recovery audit contractor responsible for reviewing durable medical equipment, hospice and home health claims on a nationwide basis, the Centers for Medicare & Medicaid Services...
Managed care plans need protection from ‘carve-outs’ to ensure services across the continuum,...
By
Tim Mullaney
Nov 26, 2014
State “carve-outs” and lack of transparency in rate-setting threaten the ability of managed care plans to support services across the whole continuum, the Medicaid Health Plans of America stated...
House leader urges HHS to end settlements meant to cut Medicare backlog
By
Tim Mullaney
Sep 17, 2014
The Department of Health and Human Services may not have had the authority to offer providers special settlements to help clear a huge backlog of Medicare appeals, a leading Congressman said in a recent...
High-profile consumer advocacy group sues over broken Medicare appeals process
By
Tim Mullaney
Aug 27, 2014
Long-term care providers have been outspoken in their criticism of the Medicare appeals process, which has all but ground to a halt. Now a class-action lawsuit says Medicare beneficiaries also are being...
Overdocumentation and cloning in electronic health records are overlooked risks, investigators say
By
Tim Mullaney
Jan 09, 2014
Auditors reviewing Medicare and Medicaid claims from electronic health records are largely treating them in the same manner as paper claims, even though they pose unique risks for overbilling and fraud,...
CMS extends overpayment payback window to one year
By
James M. Berklan
Jul 05, 2012
Federal regulators have relented and given state Medicaid programs a full year to collect and return overpayments made to providers.