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. In return, the psychiatrist prescribed Nuedexta to nursing home residents who did not have pseudobulbar affect.

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AIHC

JUNE 14, 2024

AIHC is sharing this information in support of World Elder Abuse Awareness Day. The information below is not all-inclusive or comprehensive, but it is a good start to increase awareness to educate your workforce, patients, caregivers and family members. These scams are outlined in more detail below.

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Hall Render

OCTOBER 20, 2023

Effective October 1, 2023, Connecticut enacted a law that contains several updates to Connecticut’s change of ownership laws for nursing homes and other health care providers. If the owner is a corporation that is incorporated in another state, a certificate of good standing from the state of incorporation.

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Healthcare Compliance Blog

FEBRUARY 3, 2022

A mother and her two daughters have been charged for providing fraudulent COVID-19 vaccination cards to maintain and obtain employment at a New York nursing home. Vaccination is mandatory for nursing home employment in New York. Bassett stated, “Vaccination fraud is a serious crime.

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MedTrainer

SEPTEMBER 20, 2023

Below are a variety of resource links to refer to for more information as you equip yourself with the knowledge needed to pass a survey. CMS wants the industry and public to be fully informed. There are a number of laws built to fight against Medicare/Medicaid noncompliance and fraud.

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American Medical Compliance

AUGUST 1, 2022

By analyzing fraud, waste, and abuse occurring in the medical system, the HHS is able to put regulations in place to minimize risks for patients and providers. HHS Concerned About Quality of Nursing Homes. ” Visit www.americanmedicalcompliance.com for more information. .

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

Health Care Performance

AUGUST 25, 2022

Then, forward the News Report (or excerpts) to your Board, Compliance Committee, and management team, to keep them informed with little effort. This month’s issue includes: A summary of the 48 OIG health care fraud enforcement cases announced last month. Examples of False Claims, Kickback, opioid, and state enforcement from last month.

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American Medical Compliance

AUGUST 1, 2022

By analyzing fraud, waste, and abuse occurring in the medical system, the HHS is able to put regulations in place to minimize risks for patients and providers. HHS Concerned About Quality of Nursing Homes. ” Visit www.americanmedicalcompliance.com for more information. .

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

MedTrainer

JANUARY 30, 2024

Nursing Homes: Skilled nursing facilities, long-term care facilities, and other types of nursing homes. Additionally, compliance programs address a wide range of potential issues, including fraud, waste, and abuse. Is a Compliance Program Useful If It’s Not Mandated?

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Hall Render

JULY 12, 2023

Selection Approach In establishing the proposed SFP, CMS examined the Special Focus Facility program for nursing homes and its methodology for facility selection. Initially, this information would be posted on a CMS public-facing website or a successor website. CMS’ goal is to select SFP hospices starting in 2024.

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Compliancy Group

APRIL 17, 2024

Office of Inspector General (OIG) in the Department of Health and Human Services (DHHS) oversees efforts in the healthcare sector to identify, reduce, and prevent incidents of fraud, waste, and abuse of funds from programs like Medicare. and cybersecurity threats. and cybersecurity threats.

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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. Unfortunately, Medicare Advantage programs are not exempt from instances of fraud, waste, and abuse.

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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. Office of Inspector General (OIG) Compliance Program Guidance Office of Inspector General (OIG) compliance program guidance is for individual providers like hospitals or nursing homes.

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Florida Health Care Law Firm

JANUARY 20, 2022

Essentially, the AHCA regulates and coordinates the Medicaid system and the healthcare providers that offer medical services through that program to Floridians, so there is sharing of healthcare data and resources across the state through the Florida Center for Health Information and Policy Analysis. What Are Florida AHCA Regulations?

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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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Hall Render

JANUARY 10, 2025

According to a recent roundup , the Supreme Courts overturning Chevron deference, OIG is refocusing its enforcement from pandemic-related fraud to marketing and referral practices, and the increase in private equity investment in the health care space are all areas that are likely to see an uptick in regulatory enforcement in the coming year.

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Hall Render

DECEMBER 11, 2024

The Proposed Rule would codify changes made by the Medicaid Services Investment and Accountability Act of 2019 (MSIAA), that added exclusion authorities related to misclassification and false information about outpatient drugs. Information about the LEIE may be found on the OIGs Exclusions page. Under 42 CFR Sec.

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Hall Render

NOVEMBER 10, 2023

Since the release of its first compliance program guidance (“CPG”) for hospitals in 1998, OIG has developed a series of voluntary CPGs directed at various subsets of the health care industry, such as hospitals, nursing homes, third-party billing companies, clinical laboratories, among many others.

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Hall Render

NOVEMBER 25, 2024

Department of Health and Human Services (“HHS”) issued new Industry Segment-Specific Compliance Program Guidance For Nursing Facilities (“Nursing Facility ICPG”) for nursing home members of the health care compliance community. Hall Render blog posts and articles are intended for informational purposes only.

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Healthcare Compliance Blog

JANUARY 24, 2022

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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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. This came after a 2016 guilty plea to a charge of conspiracy to commit health care fraud. By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law.

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AIHC

JUNE 3, 2024

This information can be useful when completing a Social Determinants of Health (SDOH) risk assessment and any time a health care professional determines it is necessary to gain a deeper understanding of presenting problems which are warning signs of elder physical, sexual, psychological abuse, abandonment, neglect and financial extortion.

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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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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

AIHC

FEBRUARY 16, 2024

The GCPG is a reference guide for the health care compliance community and other health care stakeholders and provides information about relevant Federal laws, compliance program infrastructure, OIG resources, and other information useful to understanding health care compliance. The accident still happens.

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AIHC

FEBRUARY 16, 2024

The GCPG is a reference guide for the health care compliance community and other health care stakeholders and provides information about relevant Federal laws, compliance program infrastructure, OIG resources, and other information useful to understanding health care compliance. The accident still happens.

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

Healthcare Law Blog

NOVEMBER 16, 2023

Department of Health and Human Services’ Centers for Medicare and Medicaid Services (“CMS”) will publish a final rule requiring Medicare skilled nursing facilities (“SNFs”) and Medicaid nursing facilities (“Facilities”) to provide more detailed ownership, managerial and other information on Form CMS-855A (the “Final Rule”). [1]

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Hall Render

MAY 20, 2022

HHS Announces $15M in Funding For Behavioral Healthcare In Nursing Homes. State Actions to Address Nursing Home Staffing During COVID-19. California aims to tighten licensing of nursing homes after pandemic exposes deadly lapses. Shortage of in-home healthcare workers sparks creative solution.

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Hall Render

JULY 26, 2024

million Medicaid grant will expand mental health services in Kansas schools New staffing mandate has some Kansas nursing homes concerned about sustainability New study ranks Missouri, Kansas among worst states for women’s health care Freeman Health System announces plan to open SEK hospital UKHS St.

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

Hall Render

JULY 26, 2024

million Medicaid grant will expand mental health services in Kansas schools New staffing mandate has some Kansas nursing homes concerned about sustainability New study ranks Missouri, Kansas among worst states for women’s health care Freeman Health System announces plan to open SEK hospital UKHS St.

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

Hall Render

OCTOBER 25, 2024

Humana sues to reverse cut to Medicare Advantage ratings Karen Lynch steps down as CVS Health CEO Nursing home survey teams don’t always have to include nurses: federal appeals court Senate report: How private equity ‘gutted’ dozens of U.S. health care company acquires three Del.

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Hall Render

JUNE 21, 2024

To Settle Telehealth Fraud Accusations State Health Dept, Hospital Association Honor Yale New Haven Hospital D.C. Supreme Court weighs future of ER abortions Flinn Foundation report identifies bioscience growth areas for Phoenix metro Medical center office building in Chandler sells for $7.3

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Hall Render

FEBRUARY 2, 2024

5 highest paid anesthesiologists in Washington, DC D.C.’s

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Hall Render

APRIL 12, 2024

in billing fraud Arizona system names new CEO Banner Health CEO Peter Fine to retire after 24 years, handing the reins to health system president Four UArizona bioscience startups selected for Flinn Foundation program Gov. Connecticut’s ‘certificate of need’ law under scrutiny Hartford HealthCare’s Black & Red Gala raises $2.6M

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Hall Render

MARCH 14, 2025

Regional Health named one of the best places to work in Kentucky UK HealthCare taps chief revenue officer LOUISIANA Louisiana opens $33M mental health hospital Louisiana physician, wife to pay $450K for neurostimulator fraud scheme Louisiana physician charged for $6.6M Vincent hospital names chief medical officer UAMS Awarded $1.9M

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Hall Render

JUNE 7, 2024

Children’s Hospital Colorado seeks congressional help on funding cuts UCHealth appoints new board members for Longs Peak, Broomfield hospitals CONNECTICUT Gov. health care is in a crisis. New data shed light. Ochsner St. Martin redirecting ambulances due to flooding MAINE MaineHealth CFO announces retirement Sen. million bird flu shots to U.S.

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Hall Render

DECEMBER 29, 2023

Here’s how to find quality care CEOs turn attention from recovery to growth ARKANSAS Statistics show many northern Arkansas locations considered maternity care deserts How broadband expansion is bolstering rural healthcare Arkansas leaders work to close gap between medical school graduates and in-state residencies Program in south Arkansas provides (..)

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