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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Nursing Homes Nurses Compliance Medicare 52

MedTrainer

NOVEMBER 6, 2023

When it comes to healthcare, compliance is not just a buzzword — it’s critical to ensuring quality of care, protecting patient privacy, and staying on the right side of the law. But what exactly is a compliance plan in healthcare, and why is it so crucial? Why Is a Compliance Plan Important in Healthcare?

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Compliance Fraud Nursing Homes Governance 52

Compliancy Group

AUGUST 31, 2023

Healthcare compliance laws play a vital role in safeguarding patients’ rights, preventing fraud and abuse, and maintaining the integrity of healthcare systems. Let’s delve into the importance of healthcare compliance laws and regulations, their impact on providers and organizations, and the guidelines governing their implementation.

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Compliance Compliance Officers Fraud Compliance Framework 52

Med-Net Compliance

JULY 26, 2022

In connection with the enforcement action, the department seized over $8 million in cash, luxury vehicles, and other fraud proceeds. Additionally, the Centers for Medicare & Medicaid Services (CMS), Center for Program Integrity (CPI), announced that it took administrative actions against 52 providers involved in similar schemes.

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Fraud Telemedicine Medicare Medicare 59

Provider Trust

AUGUST 9, 2023

Grimm, the OIG continues its tireless efforts to uncover instances of fraud, waste, and abuse within HHS programs. OIG continues to work tirelessly to identify instances of fraud, waste, and abuse and prosecute offenders. Led by acting Inspector General Christi A. What is the HHS-OIG Semiannual Report to Congress?

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Nursing Homes COVID-19 Fraud Medicaid 52

American Medical Compliance

AUGUST 1, 2022

In Spring 2022’s Semiannual Report to Congress (SAR), the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) reported that nearly $3 billion had been misspent on Medicare and Medicaid services. This includes recommending compliance programs or trainings for staff. Get Certified.

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US Department of Health and Human Services Nursing Homes COVID-19 Medicare 52

MedTrainer

SEPTEMBER 20, 2023

Watch this one-demand webinar for insider tips straight from seasoned compliance surveyors. 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. Accreditation.

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Medicaid Medicaid Medicare Medicare 97

American Medical Compliance

AUGUST 1, 2022

In Spring 2022’s Semiannual Report to Congress (SAR), the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) reported that nearly $3 billion had been misspent on Medicare and Medicaid services. This includes recommending compliance programs or trainings for staff. Get Certified.

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US Department of Health and Human Services COVID-19 Nursing Homes Medicare 52

Provider Trust

JANUARY 25, 2024

This report helps HHS fulfill its mission to improve the health and well-being of Americans while also providing suggestions for how healthcare organizations can stay ahead of the curve to avoid and combat fraud, waste, and abuse.

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Fraud Medicaid Medicaid Medicare 52

Hall Render

FEBRUARY 27, 2023

This has been a growing trend in health care enforcement, and health care fraud remained the leading source of all FCA cases in 2022. Health Care Fraud Actions Medicaid. DOJ filed claims against multiple nursing homes and their management corporation for providing services that the DOJ alleged were grossly below the standard of care.

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Nursing Homes Fraud Medicaid Medicaid 40

YouCompli

JANUARY 4, 2022

Unger, Chief of Medicaid Fraud Division, Office of the Massachusetts Attorney General; and Patrick Callahan, Healthcare Fraud Unit, US Attorney’s Office. Unger and Callahan addressed the Massachusetts Health and Hospital Association’s Healthcare Legal Compliance Forum in December 2021. Provider workload and compliance.

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Fraud Compliance Elder Abuse Medicaid 40

Hall Render

JULY 12, 2023

If a deemed hospice fails to meet the Medicare requirements or shows continued condition-level noncompliance, deemed status is generally removed and oversight is placed under the SA. Selected hospices either successfully complete the SFP program or are terminated from the Medicare program. of hospice providers reported data.

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Medicare Medicare Nursing Homes Fraud 40

Hall Render

SEPTEMBER 1, 2023

ALABAMA American Family Care opens new health care center in Northeast Birmingham doctors secure $13.9M Here’s why Ransomware gang reportedly selling Prospect Medical patient data Ransomware attack not the only headache for Prospect Medical Ridgecrest Regional Hospital receives $5.5

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COVID-19 Nurses Nursing Homes Hospitals 40

AIHC

FEBRUARY 16, 2024

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.”

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Compliance US Department of Health and Human Services COVID-19 Hospitals 52

AIHC

FEBRUARY 16, 2024

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.”

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

Hall Render

JUNE 30, 2023

for physician referral scheme In Los Angeles, hospital CEO pay could be capped Kaiser Permanente ratings affirmed amid healthy financial profile Nurses vote ‘no confidence’ in California hospital administration, board Nursing facility, management company settle physician kickback allegations for $3.8M

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US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

SEPTEMBER 16, 2022

Full 4th Circuit to tackle Medicaid fraud standard under False Claims Act. House passes reform to Medicare Advantage prior authorizations. On Average, Two Nurses Are Assaulted Every Hour, New Press Ganey Analysis Finds. Iowa nurse fired for incorrectly administering monkeypox shots. Locals are skeptical.

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US Department of Health and Human Services COVID-19 Nurses Nursing Homes 40

Verisys

NOVEMBER 20, 2022

Each month we will give a roundup of recent healthcare fraudsters and compliance busters. If you are looking for something to read prior to turkey or afterwards, here is a round up of bad actors: Pharma Fraud: . Pharma Fraud. Pharma Fraud . Pharma Fraud. Fraud Scheme. Fraud Scheme. Fraud Scheme .

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Fraud Medicaid Medicaid Nursing Homes 52

Hall Render

FEBRUARY 18, 2022

13-year Medicare payment dispute will return to HHS, court rules. Only 14% of Hospitals Met Price Transparency Rule Compliance. Aspen University investigation: Students vent frustration amid nursing board probe into private college. Nursing homes say they’re being price gouged by direct care staffing agencies.

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COVID-19 Nursing Homes Nurses COVID-19 Vaccine 40

Hall Render

AUGUST 19, 2022

Nursing homes and long-term care facilities face increased turnover, look to new solution to attract workers. Rat infestation closes Veteran Affairs nursing home in Arizona. Deadline to Close Nursing Home Extended by 2 Months. Valley nursing home workers calling for increased pay and staffing.

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COVID-19 Nursing Homes US Department of Health and Human Services Nurses 40

Hall Render

MARCH 3, 2023

on 7th medical office building acquisition in a year Baptist Health expanding in Nassau and St.

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Nursing Homes COVID-19 Nurses Hospitals 40

Hall Render

MARCH 31, 2023

in 2022, survey finds Senate votes to end COVID-19 national emergency Why are 600+ rural hospitals at risk of closing? in 2022, survey finds Senate votes to end COVID-19 national emergency Why are 600+ rural hospitals at risk of closing? buys industrial property in Rancho Cordova for $5.12

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US Department of Health and Human Services Nursing Homes Nurses COVID-19 40

Hall Render

MAY 19, 2023

operating loss in Q2 As RI legislators near session’s end, compromise on expensive proposals looks inevitable ‘It is wrong’: Charlesgate workers ask state to keep nursing home open.

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Nurses COVID-19 Hospitals Nursing Homes 40

Hall Render

SEPTEMBER 23, 2022

Healthcare Compliance Will Be a Challenge in Post-PHE World. House report attacks, nursing homes fight back over allegations of deficient staffing, care and safe practices as pandemic hit. Colorado senior-care company pauses expansion into Indiana after Medicare audit. million to resolve Medicare fraud claims.

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COVID-19 Nurses Nursing Homes Hospitals 40

Hall Render

DECEMBER 29, 2023

NATIONAL 4 largest healthcare data breaches of 2023 Anesthesia practices sue CMS over reimbursement method Antitrust enforcements hit a high in 2022, with health deals impacted ASCs face leadership exodus CMS floats appeals process over observational stays CMS proposes additional Medicare appeals processes FTC eyes healthcare mergers, report shows (..)

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Nursing Homes US Department of Health and Human Services Nurses COVID-19 40

Hall Render

FEBRUARY 24, 2023

judgment against nursing home chain over woman’s death Arkansas BCBS names VP of group market U of Arkansas to offer dual DNP-MBA program Unity Health welcomes Jacksonville community to new hospital Baptist Health Opens Behavioral Services Clinic in North Little Rock Arkansas Children’s Hospital gets $2.5

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Nursing Homes COVID-19 Nurses Hospitals 40

Hall Render

JULY 8, 2022

CMS issues updated nursing home staffing compliance guidelines. Nurse pay jumps nearly 5%. Arizona will spend millions on fixing nursing shortage. Arizona looks to address nursing shortage through new bill. Report: Arizona hospitals not in full compliance with pricing transparency laws. CALIFORNIA.

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US Department of Health and Human Services COVID-19 Nursing Homes Nurses 40

Hall Render

MARCH 8, 2024

NATIONAL 34.5% NATIONAL 34.5% NATIONAL 34.5% NATIONAL 34.5%

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Hall Render

JULY 1, 2022

Medicare’s physician pay system is ‘unsustainable,’ trustees say. Supreme Court backs HHS approach to Medicare payments for hospitals serving low-income patients. Supreme Court rules in favor of HHS in Medicare disproportionate share payments case. billion fraud. billion fraud. Louis area, nation.

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US Department of Health and Human Services COVID-19 Nurses Hospitals 40

Hall Render

MAY 5, 2023

acquisition of Oak Street Health to expand primary care footprint Did Hospitals Violate EMTALA by Failing to Provide Abortion Care? Here’s how, and why hospitals say it ‘cherry-picks data.’ of Iowa Health Care denies sharing patient data with Facebook, but are they right?

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US Department of Health and Human Services COVID-19 Nurses Hospitals 40

Hall Render

OCTOBER 20, 2023

nursing home advocate: industry in ‘death spiral’ from lack of health care providers, low pay Georgia medical center named one of the ‘most beautiful hospitals in the U.S.’

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COVID-19 Vaccine Nursing Homes COVID-19 Nurses 40

Hall Render

JANUARY 28, 2022

Hospital discharge pressures build as nursing homes clamor for help. The nursing home staffing crisis right now is like nothing we’ve seen before. Where Hospital Price Transparency Compliance Is Lagging. Where Hospital Price Transparency Compliance Is Lagging. Medicare scheme.

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Nursing Homes COVID-19 US Department of Health and Human Services Nurses 40

Hall Render

MARCH 22, 2024

To qualify, facilities must close their beds Amazon’s physician acquisition strategy As Many Hospitals Continue to Face Significant Financial Challenges, MedPAC Recommends Highest Ever Medicare Payment Update Change competitors step in but breaking up may be hard to do CMS to launch new primary care ACO program Congress unveils $1.2T

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Nursing Homes US Department of Health and Human Services Nurses Hospitals 40

Hall Render

MARCH 24, 2023

Reeves’ desk. Here’s what they are.

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Nursing Homes Nurses COVID-19 Hospitals 40

Hall Render

AUGUST 11, 2023

It costs state $1 million a month to run. million expansion plan MidState Medical Center seeks permission for $8.4M million expansion plan MidState Medical Center seeks permission for $8.4M

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US Department of Health and Human Services COVID-19 Nursing Homes Nurses 40

Hall Render

SEPTEMBER 29, 2023

in Stark law self disclosures: 3 things to know CMS’ staffing proposal will cost nursing homes $6.8B in Stark law self disclosures: 3 things to know CMS’ staffing proposal will cost nursing homes $6.8B officials, helps South Ga. officials, helps South Ga.

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US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

FEBRUARY 16, 2024

CALIFORNIA 8 ASCs opening in Florida, California and New York A bankrupt California hospital left a health care desert. CALIFORNIA 8 ASCs opening in Florida, California and New York A bankrupt California hospital left a health care desert.

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US Department of Health and Human Services Nursing Homes Nurses Hospitals 40