Pinpointing LTC enforcement trends as COVID-19 continues
By
Lauren F. Schoeberl
Apr 05, 2021
The COVID-19 pandemic has left an indelible mark on long-term care and skilled-nursing facilities. As COVID-19 cases continue to fall, regulatory and criminal enforcement agencies are now digesting...
More collaboration between Medicare and Medicaid fraud detection programs is needed, report finds
By
McKnight's Staff
Mar 22, 2012
More communication is needed between Medicare and Medicaid’s respective program integrity officials, a new report suggests.
OIG: Hospitals err 18% of the time with point-of-admission indicators
By
McKnight's Staff
Nov 28, 2012
A lack of uniformity among hospital coders for developing conditions is a main reason for the “point of admission” errors, according to a Monday report from the Department of Health and Human...
OIG: Many power wheelchairs not meeting medical necessity guidelines
Jul 12, 2011
The Department of Health and Human Services Office of Inspector General released a report that takes aim at power wheelchairs. Investigators found that 9% of power wheelchair claims in early 2007 were...
OIG to release final report uncovering CMS’ inaccurate Medicare fraud reduction claims
Aug 26, 2008
The Department of Health and Human Services’ Office of Inspector General is expected to file a final report this week criticizing the Centers for Medicare and Medicaid Services for overstating its...
OIG: Volunteer Medicare fraud patrols had declining recovery in 2011
By
McKnight's Staff
Jun 26, 2012
The success rate of Medicare’s volunteer force of fraud-detecting beneficiaries is declining, a government report finds.
When LTC leaders delegate accountability
By
John O'Connor
Nov 19, 2012
What happens when delegation without accountability takes place? We saw a good example last week, when the Office of Inspector General released a damning report about excessive Medicare charges from nursing...
OIG fraud report portends more challenges for skilled nursing
By
Kimberly Marselas
Mar 17, 2023
An annual report outlining state fraud control activities in the nation’s Medicaid facilities portends a challenging year ahead for nursing homes.
It’s all in the numbers: Compliance processes and outcomes
By
Michael Smith
Jul 24, 2019
Using data analytics we were able to pinpoint the problem and realign staffing to focus resources directly at the root cause of the issue.
Pharmacy owner pleads guilty to obstructing Medicare audit, settles for $2.5M
By
Elizabeth Newman
Aug 22, 2016
The owner of two pharmacies in Alabama has pleaded guilty to charges of obstructing a Medicare audit. He will pay a $2.5 million government penalty.