Court orders attorney to pay nursing home legal fees in ‘frivolous’ False Claims case
By
Kimberly Marselas
Feb 07, 2024
An attorney who brought a False Claims case against a Mississippi long-term care provider using publicly available — and later disproven — information must pay the facility’s legal fees, a court...
Poorly timed staff raffle can invalidate nursing home union vote: NLRB
By
Kimberly Marselas
Feb 07, 2024
A raffle offering workers thousands of dollars in prizes will likely invalidate the results of a nursing home union election, thanks to a ruling by a panel of the National Labor Relations Board.
PEPPER’s pause doesn’t wipe out prospects for nursing home self-monitoring
By
Kimberly Marselas
Feb 06, 2024
Federal regulators have suspended a key tool used by some nursing homes for internal auditing, but experts cautioned providers not to let the stoppage hinder their compliance efforts.
The RAC is back, increasing scrutiny in a complex nursing home audit environment
By
Kimberly Marselas
Feb 05, 2024
Audits of skilled nursing providers are likely to increase this year, with a growing number of federal and state recovery audits adding to specialized compliance reviews announced last year.
Providers seek incentive pay as staffing requirements ratchet up
By
Kimberly Marselas
Jan 30, 2024
A quality incentive program that directs add-on funding only to nursing homes that enhance care and perform well on a series of patient metrics could be a lifeline for hundreds of facilities facing major...
A key Medicaid advisory body appears ready to recommend new appeal opportunities for millions of Managed Medicaid beneficiaries and to add more oversight to better ensure plans cover medically necessary...
With ‘hundreds’ of facilities audited over schizophrenia, CMS pursues harsher antipsychotics stance
By
Kimberly Marselas
Jan 19, 2024
With half of nursing homes audited in a new process admitting to misdiagnosing schizophrenia patients, the Centers for Medicare & Medicaid Services is extending its drive to reduce the use of certain drugs...
New federal initiatives increase criminal enforcement concerns for nursing homes
By
Kimberly Marselas
Jan 03, 2024
Already facing heightened regulatory pressure, skilled nursing operators could find themselves the subject of more criminal investigations in 2024 with the Biden administration ramping up efforts to investigate...
Scrooged again: MA plans can’t escape criticism of clandestine coverage rules
By
Kimberly Marselas
Jan 02, 2024
If you were looking for someone deserving to be cast as Ebeneezer Scrooge this holiday season, Medicare Advantage insurers may have just locked up the audition (for this year and maybe future years too).
Genesis evades insurance shakedown over COVID cases thanks to federal ruling
By
Kimberly Marselas
Dec 20, 2023
A federal appeals court has overturned a decision that could have cost skilled nursing provider Genesis Healthcare millions of dollars in COVID-19 claims not covered by its insurer.