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,...
Provider challenging $25k fine for lack of access to dying resident’s advance directive
By
Alyssa Salela
Jul 24, 2017
A nursing home plans to challenge a $25,000 fine associated with the facility failing to include a resident advance directive in his healthcare plan, which may have contributed to his death.
Ask the Payment Expert about … keeping finances in order for 2017
By
Patricia Boyer
Feb 05, 2017
With the first month of 2017 already behind us, what are some recommendations to keep your “financial house in order” the rest of the year?
Shortchanging 850 workers will cost operator $2 million
By
Jan 06, 2017
A New York-based skilled nursing chain will pay more than $2 million in back wages and damages after underpaying nearly 850 workers, the Department of Labor announced in December.
ACA repeal may not harm providers but replacement could, leader says
By
Jan 05, 2017
Nursing home providers are unlikely to see any earth-shattering changes should the Affordable Care Act be repealed, as promised by President-elect Donald Trump. But some of the options being floated as...
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.