Bill of Health

OCTOBER 19, 2023

Advanced practice providers, such as Advanced Practice Nurses (APRNs) and Physician Assistants (PAs), are helping to fill that void. There are approximately 370,000 nurse practitioners that are licensed in the United States, and that number is growing. By Stephen Wood The number of physicians in the U.S. annually.

Nurses 274

Nurses Medicare Medicare Medicaid 274

HIT Consultant

AUGUST 6, 2023

Joel Landau, founder and chairman of The Allure Group Nursing homes have embraced technology, especially during the COVID-19 pandemic, to help seniors, staff, and clinicians better communicate with one another and for residents to stay in touch with loved ones. Nursing homes are evolving. percent of U.S.

Nursing Homes 92

Nursing Homes Nurses Medicare Medicare 92

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.

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Nurses Medicare Medicare Nursing Homes 52

The Health Law Firm Blog

MARCH 25, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On February 1, 2024, the District Court for the Southern District of Florida announced that Florida nursing home mogul Phillip Esformes had reached a plea deal on pending conspiracy [.] Indest III, J.D.,

Nursing Homes 52

Nursing Homes Nurses Fraud Medicare 52

Healthcare Compliance Blog

JANUARY 25, 2022

A Missouri woman who had previously pled guilty to Medicare and Medicaid fraud was sentenced in Federal Court to three years imprisonment and ordered to pay $7,620,779 in restitution. The DME companies would then submit the reimbursement claims to Medicare and Medicaid. General Legal Duties and Antitrust Laws.

Fraud 59

Fraud Medicaid Medicaid Medicare 59

C&M Health Law

SEPTEMBER 11, 2023

Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (“CMS”) issued a much anticipated and contested proposed rule that seeks to establish minimum staffing level requirements for nursing homes. hours of nursing staff per resident per day, or 3.0 HPRD from nurse aids (NAs). [2]

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Nursing Homes Nurses Medicaid Medicaid 98

The Health Law Firm Blog

MARCH 4, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On February 1, 2024, the District Court for the Southern District of Florida announced that Florida nursing home mogul Phillip Esformes had reached a plea deal on pending conspiracy [.] Indest III, J.D.,

Nursing Homes 52

Nursing Homes Nurses Fraud Medicare 52

Modern Healthcare

FEBRUARY 13, 2023

The Centers for Medicare and Medicaid Services published a proposed rule that aims to promote transparency in the often opaque realm of nursing home ownership.

Nursing Homes 81

Nursing Homes Nurses Medicaid Medicaid 81

Health Law RX

SEPTEMBER 14, 2021

Medicare and Medicaid certified facilities will be required to ensure that their employees are vaccinated for COVID-19, the Centers for Medicare & Medicaid Services (CMS) announced on September 9, 2021. The Interim Final Rule will apply to any healthcare facility receiving Medicare or Medicaid reimbursement.

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Medicaid Medicaid Medicare Medicare 75

The Health Law Firm Blog

MARCH 25, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that decreased overall payment rates for services provided under the Physician Fee Schedule [.] Indest III, J.D.,

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare Law Blog

FEBRUARY 12, 2024

CMS approved $500 million in infrastructure spending for NYS to establish social care networks (“ SCNs ”) to provide HRSN screening and referral services to Medicaid beneficiaries that are targeted populations for HRSN services. Medicaid Hospital Global Budget Initiative CMS authorized up to $2.2

Medicaid 52

Medicaid Medicaid Hospitals Nurses 52

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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Nursing Homes Nurses Medicaid Medicaid 96

Healthcare IT News - Telehealth

JUNE 12, 2020

introduced new legislation this week that would provide for permanent Medicare payments for telehealth services at federally qualified health centers and rural health clinics. Butterfield, D-North Carolina, and Glenn Thompson, R-Pa., " WHY IT MATTERS. ON THE RECORD.

Medicare 206

Medicare Medicare Nursing Homes Medicaid 206

Healthcare IT News - Telehealth

NOVEMBER 8, 2021

National Nurses United and the California Nurses Association released a joint statement this past week criticizing Kaiser Permanente's aims to expand advanced hospital services into patients' homes. "Nurses, more than any other healthcare staff, spend the most time with patients," said the unions in the statement.

Nurses 180

Nurses Patient Satisfaction COVID-19 Hospitals 180

Hall Render

SEPTEMBER 22, 2023

In 2023, nursing homes have seen increased citations by surveyors for noncompliance tied to their pre-dispute, binding agreements for binding arbitration with their residents. The Arbitration Regulations revised the requirements for arbitration agreements when they are used by nursing homes to resolve disputes with their residents.

Nursing Homes 73

Nursing Homes Nurses Compliance Medicaid 73

Healthcare Law Blog

AUGUST 25, 2023

On August 21, 2023, the New York State Office of the Medicaid Inspector General (OMIG) announced updates to the Medicaid overpayment self-disclosure program, which now includes an abbreviated process for reporting and explaining overpayments that are considered routine or transactional in nature and have been already voided and adjusted.

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Overpayments Overpayment Medicaid Medicaid 52

Health Care Law Brief

FEBRUARY 2, 2024

While still subject to legislative approval, the Executive Budget incorporates the recently approved amendment (“Waiver Amendment”) to New York’s Medicaid Section 1115 Demonstration that includes $7.5 billion in Medicaid investments over the next three years. Services will be delivered via a two-tiered system.

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Medicaid Medicaid Medicare Medicare 52

Healthcare Law Blog

MAY 22, 2023

With the Medicare Comprehensive Error Rate Testing program projected error rate for skilled nursing facilities (SNFs) showing a significant increase in 2022 (15.1%, up from 7.9%

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Med-Net Compliance

OCTOBER 27, 2022

A federal jury convicted a licensed Illinois psychologist of defrauding Medicare over the course of several years by causing the submission of fraudulent claims for psychotherapy services he never provided. Issue: It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent.

Nursing Homes 59

Nursing Homes Fraud US Department of Health and Human Services Nurses 59

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.

Nursing Homes 96

Nursing Homes Medicaid Medicaid Nurses 96

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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Fraud Medicaid Medicaid Nursing Homes 59

The Health Law Firm Blog

JULY 26, 2023

Board Certified by The Florida Bar in Health Law Many healthcare professionals are unaware of the adverse long-term collateral effects of Medicare revocation or exclusion on their careers and future employment. However, if you are a physician, dentist, nurse, mental health counselor, psychologist, pharmacist, physician assistant, nurse [.]

Medicare 52

Medicare Medicare Nurses Overpayments 52

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.

Medicare 59

Medicare Medicare Overpayments Overpayment 59

Hall Render

SEPTEMBER 28, 2023

Department of Health and Human Services found that most skilled nursing facilities (“nursing homes”) in Georgia that it surveyed are not correctly complying with life safety requirements or emergency preparedness requirements. The Office of Inspector General (“OIG”) of the U.S. OIG found 155 deficiencies.

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Nursing Homes Nurses COVID-19 Medicaid 40

Healthcare Law Blog

AUGUST 11, 2023

On July 13, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its proposed rule (the “Proposed Rule”) for the 2024 Medicare Physician Fee Schedule (“PFS”). CMS projects that the Proposed Rule will lead to growth in the Medicare Shared Savings Program (“MSSP”).

Medicare 52

Medicare Medicare Nurses Medicaid 52

The Health Law Firm Blog

JUNE 27, 2023

Board Certified by The Florida Bar in Health Law Many healthcare professionals are unaware of the adverse long-term collateral effects of Medicare revocation or exclusion on their careers and future employment. However, if you are a physician, dentist, nurse, mental health counselor, psychologist, pharmacist, physician assistant, nurse [.]

Medicare 52

Medicare Medicare Nurses Overpayments 52

Med-Net Compliance

AUGUST 16, 2022

Five individuals and two for-profit skilled nursing facilities (SNFs) in Pennsylvania were indicted on charges of conspiracy to defraud the United States and related healthcare fraud charges. Billing Medicare or Medicaid for services that were not provided is fraudulent activity that is often punishable by fines and imprisonment.

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Fraud Nurses Medicaid Medicaid 59

The Health Law Firm Blog

JUNE 9, 2023

Board Certified by The Florida Bar in Health Law Many healthcare professionals are unaware of the adverse long-term collateral effects of Medicare revocation or exclusion on their careers and future employment. However, if you are a physician, dentist, nurse, mental health counselor, psychologist, pharmacist, physician assistant, nurse [.]

Medicare 52

Medicare Medicare Nurses Overpayments 52

Medisys Compliance

MARCH 31, 2023

Ohio Medicaid is a government-sponsored healthcare program that provides medical benefits to eligible individuals in Ohio. To become a provider for Ohio Medicaid, you must first enroll in the Ohio Medicaid program. Here are the steps of provider enrollment for Ohio Medicaid: Provider Enrollment for Ohio Medicaid 1.

Medicaid 52

Medicaid Medicaid Licensing Medical Billing Outsourcing 52

The Health Law Firm Blog

MAY 17, 2023

Board Certified by The Florida Bar in Health Law Many healthcare professionals are unaware of the adverse long-term collateral effects of Medicare revocation or exclusion on their careers and future employment. However, if you are a physician, dentist, nurse, mental health counselor, psychologist, pharmacist, physician assistant, nurse [.]

Medicare 52

Medicare Medicare Nurses Overpayments 52

HIT Consultant

SEPTEMBER 2, 2021

What You Should Know: – The American Nurses Association (ANA) , representing the interests of the nation’s 4.2 million nurses, urges the U.S. Department of Health and Human Services (HHS) to declare the current and unsustainable nurse staffing shortage facing our country a national crisis. ”

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Nurses COVID-19 Vaccine COVID-19 Medicaid 87

The Health Law Firm

JULY 28, 2022

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

Nursing Homes 52

Nursing Homes Nurses Medicaid Medicaid 52

Hall Render

OCTOBER 10, 2023

As nursing homes look for funds to allow them to improve care and train nursing home staff, Centers for Medicare & Medicaid Services (“CMS”) released QSO-23-23-NH (“CMS Memo”), which reopens and recasts the Civil Money Penalty Reinvestment Program (“CMPRP”).

Nursing Homes 40

Nursing Homes Nurses Medicaid Medicaid 40

The Health Law Firm Blog

JANUARY 12, 2024

Board Certified by The Florida Bar in Health Law The nation's largest Medicaid insurer, Centene, has agreed to pay $165.6 million to Texas to resolve claims that it overcharged the state’s Medicaid program for pharmacy services. By George F. Indest III, J.D., The deal was signed on July 11, 2022, but wasn’t publicly [.]

Medicaid 52

Medicaid Medicaid Overpayments Overpayment 52

Med-Net Compliance

OCTOBER 26, 2022

The US Department of Health and Human Services (HHS) Office of Inspector General (OIG) has announced that they will be enhancing their focus on potentially preventable hospitalizations of Medicare-eligible skilled nursing facility (SNF) residents. Update your policies and Facility Assessment as necessary.

Nursing Homes 59

Nursing Homes Nurses US Department of Health and Human Services Hospitals 59

Hall Render

NOVEMBER 29, 2023

On November 2, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued the 2024 Medicare Physician Fee Schedule Final Rule (“Final Rule”) for calendar year (“CY”) 2024. These changes become effective on January 1, 2024. CMS anticipates the changes will increase MSSP participation by 10% to 20%.

Medicare 40

Medicare Medicare Nurses Payment Systems 40

Med-Net Compliance

AUGUST 18, 2022

An Indiana provider of skilled nursing and long-term care services has agreed to pay $5,591,044.66 to resolve allegations that it violated the False Claims Act by submitting false claims to the Medicare program. The complaint alleged that the provider had engaged in conduct to defraud the Medicare program. to the United States.

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Nursing Homes US Department of Health and Human Services Nurses Medicare 59