SNF rehab claims scrutinized more than ever, expert says
Jul 11, 2012
Nursing home administrators who can’t substantiate every minute of rehab therapy delivered in their building leave themselves open to increasingly common audits and surveys, a top MDS 3.0 expert...
After record penalties, providers can protect themselves from the DOJ with 3 priorities, experts say
By
Joe Bush
Nov 28, 2022
The Department of Justice is on pace to hand out a record $5.6 billion-plus in total fines and penalties under the False Claims Act this year, a clear indicator that the agency has removed the kid gloves...
Medicare audits ‘ramping up’ with isolation coding in the crosshairs
By
Josh Henreckson
Apr 22, 2024
Auditors are paying special attention to isolation and quarantine coding amid already heightened Medicare nursing home audits that are expected to increase in coming months, experts warn.
‘Audits are back,’ and COVID-19 care is in the hot seat
By
Kimberly Marselas
Apr 21, 2021
Flexibilities granted to providers during the ongoing public health emergency are likely to result in increased medical reviews and automated denials, a therapy billing specialist is warning.
CMS to begin audits for schizophrenia coding, says citations will affect quality ratings
By
Alicia Lasek
Jan 19, 2023
The agency will start auditing nursing homes this month to determine whether residents’ schizophrenia diagnoses are accurate and appropriately coded. A pattern of inaccurate coding may result in a quality...
Upon further review
By
Julie Williamson
Apr 01, 2013
Providers recoiling from recent uptick in therapy claim audits should expect even more scrutiny in the future as regulators look to increase surveillance.
Providers warned: Ongoing relief fund audits may bring unprecedented info demands
By
Joe Bush
Nov 21, 2022
Provider Relief Fund audits have started in earnest, with the threat of federal investigators demanding more and different data than most skilled nursing providers have ever been asked to account for.
CFOs’ 2014 challenge
By
William C. Fisher
Dec 01, 2013
Your goals as a CFO remain constant: Support the mission. Increase revenue. Consolidate across multiple entities. Budget. Implement internal controls. Facilitate audits and compliance reporting. CFOs want...