The Health Law Firm Blog

OCTOBER 5, 2023

Department of Justice (DOJ) announced it has sued three nursing homes in Ohio and Pennsylvania, citing their “grossly substandard skilled nursing services.” By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S.

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Healthcare Compliance Blog

MARCH 16, 2022

In a March 11, 2022, release by the Northern District of Georgia’s Office of the Department of Justice, it was reported that an investigation determined a Georgia nursing home knowingly submitted claims for unreasonable, unnecessary, and unskilled services for Medicare patients. Attorney Kurt R.

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Healthcare Compliance Blog

MAY 25, 2022

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has excluded a Louisiana man from participation in federal healthcare programs due to his ownership interest in seven Louisiana nursing homes that OIG previously excluded. As a result, OIG has excluded the nursing homes and their owner.

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Healthcare Compliance Blog

JANUARY 18, 2022

On January 7, 2022, the Centers for Medicare & Medicaid Services (CMS) published a memorandum stating that nursing home staff turnover and weekend staffing will be posted on the Medicare.gov Care Compare public website. The QSO memorandum can be accessed at: QSO-22-08-NH (cms.gov).

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Healthcare Law Blog

DECEMBER 7, 2022

Leveraging Oversight to Better Protect Nursing Homes – In the introduction to this Semiannual Report, Grimm indicated that “providing quality and safety of care in the more than 15,000 Medicare- and Medicaid-certified nursing homes nationwide” is a “top priority” moving forward.

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The Health Law Firm Blog

JULY 11, 2022

Department of Justice (DOJ) announced it has sued three nursing homes in Ohio and Pennsylvania, citing their “grossly substandard skilled nursing services.” By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S.

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Hall Render

JUNE 30, 2022

The Centers for Medicare & Medicaid Services (“CMS”) has given surveyors new rules and updates to allow surveyors to add extra attention and increase oversight in nursing homes regarding the quality of care and quality of life for residents. Hall Render blog posts and articles are intended for informational purposes only.

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Healthcare Compliance Blog

FEBRUARY 8, 2022

The United States has filed a lawsuit against an Alabama psychiatrist for improper prescribing of Nuedexta to nursing home residents. The complaint alleges that an Alabama psychiatrist caused the submission to Medicare and Medicaid of false and fraudulent claims for the prescription drug Nuedexta.

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McBrayer Law Blog

OCTOBER 18, 2021

More > Tags: Centers for Medicare & Medicaid Services , Civil Penalties , CMS , Healthcare Providers , Long-Term Care , Long-Term Care Facilities , Medicare. For reference, the 2017 Guidance can be found here. The accompanying CMP Analytic Tool can be found here.)

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Hall Render

MAY 2, 2023

For this alert, “nursing homes” refers to skilled nursing facilities (often known as “SNFs”). In 2020, CMS revised the nursing home infection control regulations at 42 CFR § 483.80 Additionally, this information is now publicly available on CMS’s COVID Nursing Home Data Website.

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Hall Render

JULY 5, 2023

When a patient is discharged from acute care, it is important that the acute care provider deliver accurate and appropriate patient information related to a patient’s treatment and condition in order to decrease the risk of readmission or an adverse event at the skilled nursing providers and home health agencies.

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Healthcare Law Blog

OCTOBER 27, 2022

On October 21, 2022, the Centers for Medicare and Medicaid Services (CMS) announced changes to its Special Focus Facility (SFF) program, including new steps to address nursing home facilities that fail to graduate from the SFF program in a timely manner, or “yo-yo” back into non-compliance after graduating from the SFF program.

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Hall Render

OCTOBER 27, 2023

According to a recent study , physician-owned hospitals treated some of the most expensive Medicare beneficiaries at significantly lower costs compared to traditional hospitals, despite serving similar patient populations. In the broader nursing home industry, 19% meet such minimum staffing benchmarks.

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MedTrainer

JANUARY 30, 2024

In this blog, we’ll outline what types of healthcare facilities are required by the government to have a compliance program and why compliance is crucial for both healthcare organizations and the agencies that support them. Nursing Homes: Skilled nursing facilities, long-term care facilities, and other types of nursing homes.

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Hall Render

SEPTEMBER 6, 2023

On September 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule (“Proposed Rule”) that calls for minimum staffing standards in long-term care facilities (“nursing homes”). Nursing homes would need to provide residents with a minimum of 0.55 HPRD for RNs and 2.45

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Healthcare Compliance Blog

APRIL 14, 2022

The Office of Inspector General (OIG) released their findings of an audit they conducted to determine if hospital admissions of Indiana skilled nursing facility (SNF) residents who are enrolled in both Medicare and Medicaid (dually eligible beneficiaries) were potentially avoidable, and if level-of-care requirements for Medicare were met.

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MedTrainer

SEPTEMBER 20, 2023

Examples of covered entities include health plans, clearinghouses, and certain health care providers including but not limited to: doctors, clinics, psychologists, dentists, chiropractors, nursing homes, and pharmacies. There are a number of laws built to fight against Medicare/Medicaid noncompliance and fraud. Accreditation.

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Provider Trust

AUGUST 9, 2023

Leveraging Oversight To Protect Nursing Home Residents Better Enhancing the quality of care in nursing homes remains paramount to OIG. Through years of oversight, they have discovered various obstacles and weaknesses within nursing home facilities.

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Healthcare Law Blog

DECEMBER 1, 2023

HHS-OIG conducted investigations resulting in 661 criminal actions against individuals related to Medicare and Medicaid, as well as 726 civil actions, including false claims, unjust-enrichment lawsuits, and civil monetary penalty settlements. Enhancing program integrity in noninstitutional care settings, such as home health and hospice care.

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Healthcare Law Blog

NOVEMBER 2, 2023

According to the Congressional Research Service, which analyzed data from the Centers for Medicare & Medicaid Services (“CMS”) National Health Expenditure Accounts (“NHEA”) on the personal health expenditures for LTSS by payer, in 2021, an estimated $467.4 As individuals continue to live longer beyond retirement and the U.S.

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Provider Trust

JULY 17, 2023

Their guidance aims to improve a number of potential risks within the healthcare space by improving care at nursing homes and strengthening the program integrity in managed care. OIG pointed to the increased instances of patient neglect abuse as well as the need for oversight within nursing homes.

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Hall Render

APRIL 11, 2022

Last week, CMS proposed increases in Medicare rates for certain health care services, and Florida’s governor signed legislation that ensures patients of hospitals and health care facilities are allowed to have visitors. In other news, a large committee of experts issued a report on the nursing home industry that was less than flattering.

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Healthcare Law Blog

SEPTEMBER 6, 2023

On September 1, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a long-awaited proposal to establish new federal minimum staffing standards for long-term care facilities. [1] Nurse Aide (NA) HPRD (the “2.45 Nurse Aide (NA) HPRD (the “2.45 55 RN hours per resident per day (the “.55 55 RN HPRD”); and At least 2.45

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Health Law Attorney

JANUARY 13, 2022

The Centers for Medicare and Medicaid Services (“ CMS ”) has also taken recent action to implement a COVID-19 vaccine mandate. In November 2021, CMS issued an Interim Final Rule (“ IFR ”) that would require facilities receiving Medicare and Medicaid funding to ensure that their staff are vaccinated against COVID-19.

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Hall Render

JANUARY 11, 2022

Facing further confusion from skilled nursing facilities and families amidst the current spike in COVID cases in the United States, the Centers for Medicare & Medicaid Services (“CMS”) released additional best practices and addressed more issues that skilled nursing providers should follow as they encounter certain visitation scenarios.

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Hall Render

JANUARY 18, 2022

Amidst a nationwide nursing and skilled nursing facility staffing crisis, the Centers for Medicare & Medicaid Services (“CMS”) announced that additional information regarding nursing home staff numbers will be added to the January 2022 CMS Care Compare website. Weekend Staff.

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Healthcare Compliance Blog

MAY 18, 2022

The program is funded by the Centers for Medicare & Medicaid Services (CMS), and will establish a Center of Excellence for Building Capacity in Nursing Facilities to Care for Residents with Behavioral Health Conditions (Center for Excellence).

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Healthcare Compliance Blog

JANUARY 24, 2022

The Medicaid Fraud Division also prioritizes the physical and financial security of residents who reside in Massachusetts nursing homes. Cases include: In September 2021, a certified nurse’s aide was charged with sexually assaulting two elderly nursing home residents at a Massachusetts nursing home while he worked the night shift.

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New Jersey Healthcare Blog

NOVEMBER 8, 2022

In October 2022, Centers for Medicare & Medicaid Services (CMS) made some significant changes to the Special Focus Facility (SFF) program that raise the bar for completion of the program and that increases enforcement actions for nursing homes that fail to demonstrate improvement. See 42 U.S.C. §§ 1819(f)(8), 1919(f)(1).

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Provider Trust

JANUARY 25, 2024

Ensuring the Financial Integrity of HHS Programs In fiscal year (FY) 2022, improper payments within healthcare programs like Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) were estimated at a staggering $131.6 Managed care now covers more than half of Medicare enrollees and over 80% of Medicaid enrollees.

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Healthcare Law Blog

DECEMBER 19, 2022

In 2021, COVID-19 immunization rates among nursing home staff quickly rose due to federal vaccine mandates for healthcare workers and long-term care facilities participating in the Federal Pharmacy Partnership for Long-Term Care Program. viii] Who We Help – Nursing Homes | qioprogram.org. pdf (federalregister.gov).

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Hall Render

MAY 11, 2023

As skilled nursing facilities work and provide health care services after the May 11, 2023, end of the Public Health Emergency, questions and concerns about visitation at these facilities will likely continue to arise. Hall Render blog posts and articles are intended for informational purposes only.

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Pharmacy Law Blog

FEBRUARY 13, 2018

On November 22, 2017, a Florida woman who was accused of a $45 million Medicare fraud, received a six-and-a-half-year prison sentence, following a 2016 U.S. Prior to her guilty plea, she was accused of Medicare fraud and Anti-Kickback Statute violations allegedly through paying patients. By George F. Indest III, J.D.,

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Hall Render

NOVEMBER 18, 2022

On November 2, 2022, CMS announced revisions to the Calendar Year 2023 Payment Policies that impact Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare and Medicaid Provider Enrollment Policies (“CY 2023 PFS Final Rule”).

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MedTrainer

OCTOBER 27, 2020

Keys to managing point-of-care testing complianceIn an effort to combat the spread of the virus and to help nursing homes protect the health and safety of their residents, the U.S. To be eligible, nursing homes must have a current CLIA Certificate of Waiver and meet certain epidemiological criteria.

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MedTrainer

JANUARY 10, 2024

Centers for Medicare and Medicaid Services (CMS) requires nursing homes and ambulatory surgery centers (ASCs) to have an individual who is qualified by experience and training to serve as an infection control preventionist. Evaluate your current infection control and prevention plan.

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MedTrainer

NOVEMBER 6, 2023

While specific compliance requirements vary depending on the type of facility — from large hospitals and surgery centers to clinics and nursing homes — having a well-structured compliance plan is essential for all medical settings. But what exactly is a compliance plan in healthcare, and why is it so crucial?

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