MDS draft sends sector, states scrambling to assess effects
By
Joe Bush
Sep 07, 2022
Long-term care facilities, staff and half the states in the US should start preparing immediately for extensive changes to the Minimum Data Set, resident assessment experts said this week.
Could everything be a kickback?
By
Chris Sabis
Dec 15, 2021
The U.S. District Court for the Middle District of Tennessee recently issued a number of rulings interpreting the federal False Claims Act (FCA) and its state law counterparts relevant to long-term care...
Federal court opens door for nursing homes to challenge Medicare, Medicaid rules
By
Danielle Brown
Apr 30, 2021
Providers may challenge rules and regulations established by federal agencies that they believe violate the Medicare and Medicaid Acts, thanks to a ruling this week by a federal court.
False Claims suit against Omnicare, CVS Health dismissed in appeals court
By
Danielle Brown
Aug 20, 2020
Omnicare and parent company CVS Health earned a court victory this week after a federal appeals court agreed to dismiss a whistleblower’s False Claims Act lawsuit for an alleged kickback scheme.
Beneficiaries again challenge slow Medicaid application process
By
Elizabeth Newman
Jul 10, 2018
Connecticut has failed to process Medicaid applications in an agreed-upon time frame, including for long-term care beneficiaries, and a court should hold it in contempt, a new filing alleges. But the state...
Vetoed proposal to limit Medicaid drugs a win for manufacturers, patients
By
Meredith Beirne
Jun 29, 2018
The Centers for Medicare & Medicaid Services has rejected a state proposal to limit Medicaid drugs for beneficiaries in an effort to lower costs.
Still no word on whether CMS will approve lifetime Medicaid limits
By
Kimberly Marselas
Mar 26, 2018
Lawmakers and reporters alike have been unable to pin down Centers for Medicare & Medicaid Services Administrator Seema Verma on her agency’s view of states’ requests to impose lifetime coverage...
Court allows SNF to sue state over refusal to pay Medicaid bills
By
Nov 28, 2017
A North Carolina skilled nursing facility will be allowed to pursue a case against the state’s Medicaid agency after it denied payment for residents who couldn’t pay their share of their bill...
Medicaid chief announces new ‘vision’ for program — and policies to reduce regulatory burden
By
Nov 08, 2017
The future of Medicaid will include a stronger focus on the relationship between the federal and state governments, as well fewer barriers to innovation within the program, the head of the program shared...
When the star goes down and payment’s involved, beware
By
James M. Berklan
Jul 22, 2016
A leader in the quest to increase long-term care insurance activity delivered a blow to its followers this week. The fallout might not be pretty.