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New York Optician Convicted of Medicaid Fraud for Nursing Home Residents

Healthcare Compliance Blog

A New York optician has pled guilty to grand larceny for submitting false claims for optician services that he alleged were for specific nursing home residents, but which were never provided. On January 27, 2022, he was sentenced to 90 days in state prison, followed by 5 years’ probation, and was ordered to pay $74,00 in restitution.

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CMS Proposes Minimum Staffing Requirements and Enhanced Facility Assessments for Nursing Homes

C&M Health Law

Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (“CMS”) issued a much anticipated and contested proposed rule that seeks to establish minimum staffing level requirements for nursing homes. hours of nursing staff per resident per day, or 3.0 HPRD from nurse aids (NAs). [2]

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HHS & DOJ FY 2022 Enforcement Targeted Fraud in COVID-19, Telemedicine, Opioid and Prescription Drugs, and Substance Use Treatment Centers, Among Other Initiatives

Healthcare Law Blog

The Department of Health and Human Services (HHS) and the Department of Justice (DOJ) recently released its “Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2022 ” (the “Report”), highlighting continued enforcement and recovery actions under the Health Care Fraud and Abuse Control Program (HCFAC).

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Nursing Home Investigation Leads to Michigan Sentinel Project’s First Criminal Case

Healthcare Compliance Blog

Complaints of resident abuse in a Michigan nursing home led to an investigation by the Michigan Office of Attorney General’s Health Care Fraud Division, working with the Michigan Sentinel Project. The investigation determined that a nurse was working at the nursing home while her license was suspended, which is a felony.

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Avamere Holdings Facing Class Action Lawsuit Over 2022 Cyberattack

HIPAA Journal

The Wilsonville, OR-based home health care service provider and nursing home operator, Avamere Holdings, is facing a class action lawsuit over a major data breach that affected 96 senior living and healthcare facilities and resulted in the exposure of the protected health information of more than 380,000 individuals.

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North Dakota CNA Found Guilty after Injuring Nursing Home Resident by Improper Lifting

Med-Net Compliance

The evidence at the trial showed that the CNA performed an improper, one-person lift of a nursing home resident which resulted in severe and painful injuries to the resident. The CNA is being held in custody until the date of her sentencing hearing on November 29, 2022. “[The

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Massachusetts Medicaid Fraud Division Recovers Over $55 Million in 2021

Healthcare Compliance Blog

On January 19, 2022, the Massachusetts Medicaid Fraud Division announced that in calendar year 2021, more than $55 million was recovered from individuals and entities who defrauded the state. The Attorney General’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state Medicaid program, MassHealth.

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