MedTrainer

AUGUST 1, 2022

Medicare and Medicaid services are the backbone for supporting elderly and disabled Americans. However, there have been many cases of individuals and parties abusing Medicare regulations for their own financial gain — and medical professionals and organizations within the healthcare industry are among them. A Look at the OIG.

Nurses 52

Nurses Medicare Medicare Nursing Homes 52

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.

Nursing Homes 52

Nursing Homes Nurses Compliance Medicare 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.

Fraud 59

Fraud Telemedicine Medicare Medicare 59

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. Medicare Advantage (M.A.): and cybersecurity threats. Organizations using M.A.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 52

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?

Nursing Homes 52

Nursing Homes COVID-19 Fraud Medicaid 52

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.

Compliance 52

Compliance Nursing Homes Nurses Fraud 52

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.

Fraud 40

Fraud Medicare Medicare Governance 40

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. HHS Examines Medicare Spending and COVID-19 Tests. HHS Concerned About Quality of Nursing Homes.

US Department of Health and Human Services 52

US Department of Health and Human Services Nursing Homes COVID-19 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. HHS’s suspension and debarment programs are vital to upholding integrity in Federal grants and contracts.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

MedTrainer

JANUARY 30, 2024

Compliance is Mandatory for Federal Programs One constant is that organizations and facilities that participate in federal healthcare programs, such as Medicare and Medicaid, must have a compliance program. Nursing Homes: Skilled nursing facilities, long-term care facilities, and other types of nursing homes.

Governance 52

Governance Compliance Nursing Homes Medicaid 52

MedTrainer

JANUARY 10, 2024

The OIG is making major investments to systematically detect and prosecute fraud. In this guidance it’s clear the OIG expects healthcare organizations and suppliers to understand their role and responsibilities to fight fraud, waste, and abuse. We all should be a LOT more prepared!

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Compliance Fraud HIPAA Compliance Officers 94

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. HHS Examines Medicare Spending and COVID-19 Tests. HHS Concerned About Quality of Nursing Homes.

US Department of Health and Human Services 52

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

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.

Medicaid 97

Medicaid Medicaid Medicare Medicare 97

Health Care Performance

AUGUST 25, 2022

This month’s issue includes: A summary of the 48 OIG health care fraud enforcement cases announced last month. The OIG's audit report of nursing home life safety and emergency preparedness noncompliance. The OIG's audit report of nursing home life safety and emergency preparedness noncompliance. Price: $300/year.

Compliance 52

Compliance Nursing Homes HIPAA Fraud 52

The Health Law Firm

AUGUST 8, 2017

It is reported that Blanco oversaw inspections by the Florida Agency for Health Care Administration or "AHCA" of Florida nursing homes owned by Phillip Esformes. Bertha Blanco faces a wide range of charges including accepting bribes to tip off individuals when state wide investigations were to begin. The Ring Alleged Ring Leader.

Governance 40

Governance Fraud Nursing Homes Medicare 40

Hall Render

APRIL 19, 2024

to Study Treatments for Vascular Abnormalities Federal Appeals Court Hears Arguments on Nation’s First Ban on Gender-affirming Care for Minors Jason Demke Hired as COO at Mercy Hospital Fort Smit Pulaski Tech Awarded $5.7M

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

The Health Law Firm

JANUARY 2, 2013

The Office of Inspector General (OIG) of the US Department of Health and Human Services (HHS) is investigating a Tennessee-based nursing care company. The company runs more than 200 skilled nursing homes (SNFs), assisted living facilities (ALFs), retirement living communities, home care services, and Alzheimer's centers across the country.

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Medicare Medicare 40

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.

Compliance 52

Compliance Compliance Officers Fraud Compliance Framework 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.

Nursing Homes 40

Nursing Homes Fraud Medicaid Medicaid 40

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?

Compliance 52

Compliance Fraud Nursing Homes Governance 52

Med Law Blog

MAY 1, 2023

Howell, Constantine Yannelis and Abhinav Gupta positing that their research shows that “PE ownership increases short term mortality of Medicare patients by 10%, in nursing homes”.

Nursing Homes 52

Nursing Homes Malpractice Hospitals Nurses 52

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 reported that her unit is focused on about 65% Medicare fraud and about 35% abuse and neglect. Millions in dollars in fraud are happening this way,” Callahan said.

Fraud 40

Fraud Compliance Elder Abuse Medicaid 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

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

Hall Render

JULY 28, 2023

million for rural hospital expansion Hospices in Arizona & other states receive scrutiny over concerns of fraud, waste & abuse Phoenix Children’s Building New 44,000-Square Foot Level IV Neonatal Intensive Care Unit Firefighters oppose Banner’s planned $400M hospital There’s a growing nurse shortage in Arizona.

US Department of Health and Human Services 40

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

Medicare 40

Medicare Medicare Nursing Homes Fraud 40

Hall Render

APRIL 22, 2022

GAO investigating private equity ownership of nursing homes. This nursing home chain reported the highest COVID death rate. San Francisco’s Laguna Honda Hospital Loses Medicaid, Medicare Funding. Sutter Health: Nurses who staged 1-day strike must wait 5 days to return to work. Then it deleted deaths.

COVID-19 40

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

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

US Department of Health and Human Services 40

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

Hall Render

NOVEMBER 4, 2022

AMA scrutinizes lack of competition, consumer harms in Medicare Advantage plans. CMS gives nursing homes a longer leash on staff COVID-19 vaccination requirements. CMS makes big changes to Medicare Shared Savings Program. In Bethel, a homegrown solution to the state’s nursing shortage. percent in final rule.

US Department of Health and Human Services 40

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

Hall Render

MAY 20, 2022

HHS Announces $15M in Funding For Behavioral Healthcare In Nursing Homes. OIG: 25% of Medicare hospital patients experienced harm pre-pandemic. State Actions to Address Nursing Home Staffing During COVID-19. California aims to tighten licensing of nursing homes after pandemic exposes deadly lapses.

COVID-19 40

COVID-19 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.

US Department of Health and Human Services 40

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

Hall Render

MAY 13, 2022

Prism pays $650K to settle Medi-Cal fraud claims filed in San Diego. Nursing Home Operator Leaving 8 Locations. COVID outbreaks strike 8 nursing homes as cases rise across Maine. Massachusetts to receive $250,000 from 5 nursing homes over patient neglect, inadequate care claims. CALIFORNIA.

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

Hall Render

JANUARY 5, 2024

Wade; expected to remain big issue in 2024 races Most nursing home residents in Arizona still haven’t gotten their COVID-19 booster COVID-19 hospitalizations are up in Arizona and around the U.S. Retina Group of Washington reports massive data breach A trifecta of viruses in the D.C.

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COVID-19 Nursing Homes Nurses Hospitals 40

Verisys

NOVEMBER 20, 2022

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. A psychiatrist caught improperly billing over $1.36M to Medicare over the course of seven years. Fraud Scheme. Fraud Scheme.

Fraud 52

Fraud Medicaid Medicaid Nursing Homes 52

Hall Render

DECEMBER 1, 2023

1 Mass General Brigham to build AI products with Australian health tech company Mass General Brigham hospital workers to receive average 21% raises Mass General Brigham to integrate triage AI across system Mass General Brigham sued over infection control lapse Nurse practitioner pleads guilty to $7.8M

Nursing Homes 40

Nursing Homes Nurses Ransomware COVID-19 40

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]

Nurses 52

Nurses Medicaid Medicaid Medicare 52

Hall Render

FEBRUARY 18, 2022

13-year Medicare payment dispute will return to HHS, court rules. Aspen University investigation: Students vent frustration amid nursing board probe into private college. ‘I feel extorted:’ Former FMC nurses told to pay $5K after being fired for refusing vaccine. Florida physician convicted of $110M fraud.

COVID-19 40

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.

COVID-19 40

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