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Medicare Patients Win the Right to Appeal Gap in Nursing Home Coverage

Kaiser Health News

A three-judge federal appeals court panel in Connecticut has likely ended an 11-year fight against a frustrating and confusing rule that left hundreds of thousands of Medicare beneficiaries without coverage for nursing home care, and no way to challenge a denial. But it can have serious repercussions.

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Policy Reversal Means Return of Per Day Fines for Nursing Homes

McBrayer Law Blog

For reference, the 2017 Guidance can be found here. More > Tags: Centers for Medicare & Medicaid Services , Civil Penalties , CMS , Healthcare Providers , Long-Term Care , Long-Term Care Facilities , Medicare. The accompanying CMP Analytic Tool can be found here.)

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Nursing Home Provider to Pay over $5.5M in Civil False Claims Settlement

Med-Net Compliance

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 Home Update: CMS Updates and Expands Surveyor Guidance for Nursing Homes for Phase 2 and 3 Requirements of Participation – Key Areas and Timeline

Hall Render

The Centers for Medicare & Medicaid Services (“CMS”) has given surveyors new rules and updates to allow surveyors to add extra attention and increase oversight in nursing homes regarding the quality of care and quality of life for residents.

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Webinar Recap: OIG’s 2023 Guidance for Navigating Compliance Changes

Provider Trust

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.

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The PACE Solution to Increasing Demands for Long-Term Services and Supports in the U.S.

Healthcare Law Blog

According to the Congressional Research Service, which analyzed data from the Centers for Medicare & Medicaid Services (“CMS”) National Health Expenditure Accounts (“NHEA”) on the personal health expenditures for LTSS by payer, in 2021, an estimated $467.4 As individuals continue to live longer beyond retirement and the U.S.

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Bridges Health Partners Highmark BCBS Form Commercial Value-Based Care Agreement

HIT Consultant

This agreement builds on the successful results of the Value-Based Agreements Bridges and Highmark entered in January 2022 for Highmark’s Medicare Advantage members and the January 2020 Agreement for the Highmark Wholecare membership. Established in 2017 through a collaboration between Independence Health System, St.