CMS finalizes long-awaited prior authorization rule for Medicare Advantage
By
Josh Henreckson
Jan 18, 2024
A new rule on Medicare Advantage prior authorization finalized by the Centers for Medicare & Medicaid Services Wednesday suggests good news for providers and Medicare recipients.
Nursing home illegally blocked union access: Judge
By
Josh Henreckson
Jan 17, 2024
A nursing home violated federal labor law by unilaterally limiting union access to its facility, threatening legal action and calling the police to enforce that restriction, a National Labor Relations...
$96M Medicaid funding gap menaces state’s facilities, threatens closures
By
Josh Henreckson
Jan 17, 2024
Persistent and growing Medicaid funding gaps have pushed Maine long-term care leaders to request urgent relief from the state government. The LTC reimbursement shortfall has expanded to $96 million dollars,...
$2K daily fines poised to begin ‘within days’ as NY staffing rule upheld
By
Josh Henreckson
Jan 16, 2024
Long-term care providers took a legal blow when a New York state Supreme Court judge struck down a legal challenge to the state’s staffing mandate law, and now providers could be days away from incurring...
25 nursing homes swept up in wage-withholding investigation
By
Josh Henreckson
Jan 11, 2024
The US Department of Labor has filed a complaint against the operator of 25 Massachusetts nursing homes, alleging that it systematically withheld break and overtime pay at those facilities in violation...
Nursing operator must issue back pay after abruptly ending shift-differential perk
By
Josh Henreckson
Jan 09, 2024
The National Labor Relations Board sided with a union’s request to have shift-differential pay reinstated and back pay issued after a nursing home’s new owner unilaterally ended the incentive practice...
Long-term care leaders cheer proposed Medicare Advantage appeals rule in final push
By
Josh Henreckson
Jan 08, 2024
A surge of public and professional support arrived Friday as the comment period closed for a proposed federal rule that providers say could level the playing field with Medicare Advantage plans.
CMS proposes appeals process for Medicare patients placed on observation stay
By
Josh Henreckson
Jan 02, 2024
Medicare patients initially admitted to hospitals as inpatients but later reclassified as outpatients under observation would finally have a process to appeal those decisions, thanks to a long-awaited...
Class action suit targets Medicare Advantage insurer’s use of AI to end rehab stays
By
Josh Henreckson
Dec 14, 2023
Two skilled nursing patients filed a class action suit against Humana Tuesday — alleging their Medicare Advantage benefits were cut prematurely short because of Humana’s wrongful reliance on artificial...
Nursing home thrust into controversy after dangling KitchenAid prize for 5-star reviews
By
Josh Henreckson
Dec 14, 2023
Nursing homes are always under pressure to receive stellar online reviews. But the aggressive tactics of one Massachusetts facility has raised questions of how far they should go to get 5-star reviews. ...