Draft bill proposes counting observation stays for SNF coverage, limiting RAC oversight
By
Tim Mullaney
Nov 24, 2014
Hospital observation stays would count toward establishing Medicare eligibility for post-acute services, under comprehensive reforms in a new draft bill from the House Committee on Ways and Means. The...
CMS clarifies 45-day deadline for additional documentation requests
By
Tim Mullaney
Nov 19, 2014
Certain auditors that are doing prepayment reviews of Medicare claims must tell providers that they have 45 days to produce any additional documents requested (ADR), according to a recent Survey & Certification...
Providers, CMS at odds over dual eligible program
By
Tim Mullaney
Nov 13, 2014
Some nursing homes and other providers are engaging in “bad behavior” by trying to persuade people to opt-out of a managed care demonstration project, a top government official recently claimed....
FEMA tells assisted living residents to pay back Hurricane Sandy aid
By
Tim Mullaney
Nov 11, 2014
Residents of a New York City assisted living center recently received letters from the Federal Emergency Management Agency demanding they repay thousands of dollars in Hurricane Sandy aid.
Government asks for suggestions on how to reduce Medicare appeals backlog
By
Tim Mullaney
Nov 05, 2014
The federal government is asking the public to suggest ways of reducing Medicare appeals and cutting down on a backlog at the administrative law judge level. The request for information was filed by the...
FL hospice, nursing homes, hospital passed patients back and forth to juice profits, whistleblowers charge
By
Tim Mullaney
Oct 29, 2014
Two Florida nursing homes and a hospital allowed a hospice company to provide free services in exchange for patient referrals, according to recently unsealed whistleblower charges.
Judge approves $38 million settlement in ManorCare case
By
Tim Mullaney
Oct 27, 2014
HCR ManorCare will pay $38 million under a legal settlement recently approved by a judge in West Virginia. The award to plaintiffs was originally $91 million until the state Supreme Court reduced it in...
Omnicare off the hook in drug packaging case after Supreme Court passes
By
Tim Mullaney
Oct 09, 2014
Long-term care pharmacy Omnicare will not face False Claims Act penalties for drug packaging practices that apparently ran afoul of safety regulations. The U.S. Supreme Court has declined to take up the...
AHCA: Managed care transparency needed
By
Tim Mullaney
Oct 01, 2014
The government should collect and release more claims information from managed care plans, the nation’s largest long-term care provider association stated in a recent letter to Senate leaders.
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...