Feds target individuals, not just companies, in healthcare fraud cases
Jun 01, 2011
In an effort to crack down on healthcare fraud repeat offenders, the federal government is going after individuals at nursing home chains, drug companies, medical device manufacturers and other providers...
Report: Nursing home therapy reimbursement under review as reform law toughens up
Mar 30, 2010
Healthcare analysts at the Department of Health and Human Services are re-evaluating Medicare’s “ultra-high” billing category for therapy services in skilled nursing facilities as a potential...
Lawmakers call for public disclosure of Medicare payments, ask for input on post-acute reforms
By
McKnight's Staff
Jun 20, 2013
The battle against Medicare waste, fraud and abuse heated up on Capitol Hill this week. Lawmakers introduced a bill to make Medicare claims and payments publicly available and asked for provider input...
Veterans Affairs plans to borrow from the CMS fraud-prevention playbook
By
Kimberly Marselas
Jan 24, 2018
The Centers for Medicare & Medicaid Services will share its best fraud prevention tactics used against nursing homes and other providers with the U.S. Department of Veterans Affairs, the agencies said...
Obama’s FY 2011 budget to extend FMAP increase, ramp up anti-fraud efforts
Feb 01, 2010
President Obama is scheduled to unveil his FY 2011 federal budget proposal today. The blueprint would provide states with some additional Medicaid funding and crack down on Medicare and Medicaid fraud.
Senators blast Medicare audits, say RAC payments should be changed
By
Tim Mullaney
Jul 10, 2014
The Medicare claims review process is unfairly burdening healthcare providers and failing to improve program integrity, due in part to the payment system for certain auditors, Senate leaders said during...
NY nursing home to pay up to $8.6M, make major reforms to resolve criminal fraud charges
By
Josh Henreckson
Mar 05, 2024
A settlement with the New York Attorney General’s office will require a Long Island nursing home to pay up to $8.6 million in Medicare and Medicaid restitution and funding for state-mandated changes...
Brokers stole dying nursing home residents’ identities to carry out a lucrative fraud, SEC charges
By
Tim Mullaney
Mar 14, 2014
Two investment brokers and their associates are facing charges that they stole nursing home residents’ personal information to perpetrate annuities fraud, the U.S. Securities and Exchange Commission...
Judge denies appeal by Burkhart, former American Senior Communities CEO serving 10 years for audacious...
By
Kimberly Bonvissuto
May 18, 2021
A federal judge has denied a motion by former American Senior Communities CEO James Burkhart to throw out his felony fraud convictions, ruling that his law firm’s conflict of interest did not adversely...
Private equity in the crosshairs
By
Jonathan H. Ferry
Aug 20, 2021
Private equity investors in nursing homes should brace and prepare for an active near-term enforcement environment. Congressional skepticism of private equity involvement in healthcare, developments in...