YouCompli
DECEMBER 14, 2022
Sharon Parsley, JD, MBA, CHC, CHRC contributes a monthly post on compliance officer effectiveness for the YouCompli blog. In this article she looks at specific ways to engage and communicate with Nursing, Physicians, Sales & Marketing, Revenue Cycle, and IT. In an inpatient setting, nursing is going to be a 24×7 business.
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. This amount was based on the nursing home’s ability to pay.
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YouCompli
MAY 17, 2023
Sharon Parsley, JD, MBA, CHC, CHRC contributes a regular post on compliance officer effectiveness for the YouCompli blog. What does it really take to ensure that an organization has a mature, well-integrated, and high-performing Compliance function? Hopefully, both Compliance and Legal are involved in your contract approval processes.
Health Care Law Brief
APRIL 12, 2023
We note, however, that an MA plan may elect to offer, as a Medicare benefit, coverage for post-hospital skilled nursing facility care without a prior qualifying hospital stay that is required under traditional Medicare. Final Rule at p. 3729(b)(1)(A) of the False Claims Act (“FCA”). See Proposed Rule at 79559. See 42 U.S.C. See 42 C.F.R.
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.
Healthcare IT Today
NOVEMBER 22, 2022
Auditors may also perform technical audit reviews, medical necessity compliance reviews, and medical policy reviews. The payer could also recoup the overpayments from future visits. . Meanwhile, Medicare also has a Fee for Service Recovery Audit Program. What Triggers Audits? . There are only so many hours in the day.
Healthcare Law Blog
FEBRUARY 9, 2024
million to resolve a lawsuit filed by the system’s former Chief Compliance Officer, Ronald Sherman. However, ChristianaCare employees – including hospitalists, residents, physician assistants, and nurse practitioners – worked in the NICU alongside Neonatology Associates, and were also providing care to these same patients.
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