Indiana has recommended several companies to provide Medicaid managed care to seniors but by early October had yet to issue $15 billion in contracts.
Lawmakers pushing CMS to ease Medicare Advantage prior authorizations
By
Kimberly Marselas
Jun 26, 2023
Close to 300 members of Congress are urging federal regulators to do more to reduce burdensome Medicare Advantage requirements that can slow delivery of care to nursing home and other patients.
Federal COVID cases with major LTC implications headed for November action
By
Kimberly Marselas
Oct 28, 2022
Two cases that could play a pivotal role in determining how well skilled nursing providers are protected by a federal COVID shield law are headed for important federal court dates.
AI-shortened nursing home stays drive potential class action suit against insurer
By
Kimberly Marselas
Nov 16, 2023
The nation’s largest insurer is illegally using programs driven by artificial intelligence to override the decisions of medical professionals and wrongfully force seniors from nursing homes, a potential...
CMS provides first look at shorter, Risk-Based Survey process
By
Kimberly Marselas
Apr 04, 2024
The Centers for Medicare & Medicaid Services on Wednesday revealed initial information about a potential “Risk-Based Survey” option that could be available to some of the nation’s best performing...
Key senator pressures state survey agencies over staffing-related delays
By
Kimberly Marselas
Sep 13, 2022
Sen. Bob Casey Jr. (D-PA) is demanding state survey agencies report information on extensive delays, staffing shortages and other challenges in the nursing home inspection process.
Diversicare, therapists hit with $1.4M settlement over moonlighting allegations
By
Kimberly Marselas
Jul 13, 2023
Diversicare Healthcare Services and two occupational therapists have agreed to pay nearly $1.4 million to resolve claims that the provider “condoned” therapists who clocked into nursing homes and then...
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...
Mega-merger that would fold Good Sam, Ebenezer into one organization faces new scrutiny
By
Kimberly Marselas
Mar 08, 2023
Weeks after agreeing to delay its merger efforts to appease Minnesota regulators, Good Samaritan Society’s parent company is facing a fresh challenge in South Dakota.
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...