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According to court documents and evidence presented at trial, the psychologist caused the submission of fraudulent Medicare claims from July 2016 through June 2019 for psychotherapy services purportedly provided to nursinghome residents in Chicago and surrounding areas.
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 nursinghomes. hours of nursing staff per resident per day, or 3.0 HPRD from nurse aids (NAs). [2]
A New York optician has pled guilty to grand larceny for submitting false claims for optician services that he alleged were for specific nursinghome residents, but which were never provided. Additionally, it is necessary that the billing office ensures that no double billing occurs by the nursinghome and any consultant.
Complaints of resident abuse in a Michigan nursinghome led to an investigation by the Michigan Office of Attorney General’s Health Care Fraud Division, working with the Michigan Sentinel Project. The investigation determined that a nurse was working at the nursinghome while her license was suspended, which is a felony.
An Oklahoma nurse aide pleaded guilty to abusing a nursinghome resident and was placed on a deferred sentence probation for three years under the supervision of the Oklahoma Department of Corrections. toward the cost of the investigation to the Office of the Attorney General Medicaid Fraud Control Unit (MFCU), $300.00
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.
A nursinghome health system has agreed to pay the United States $1.75 A nursinghome health system has agreed to pay the United States $1.75 The company is a not-for-profit corporation located in Florida that oversees healthcare facilities on its campus, including a nursinghome and an assisted living facility.
Department of Health and Human Services (HHS) issued new Industry Segment-Specific Compliance Program Guidance For Nursing Facilities (Nursing Facility ICPG) for nursinghome members of the health care compliance community. Medical Directors in NursingHomes 42 CFR 483.70(g)
A South Carolina man has been arrested for financial transaction card fraud and exploitation of a vulnerable adult who was a resident of a nursinghome. Due to his past criminal record, he also faces enhancement to the financial transaction card fraud charge.
In connection with the enforcement action, the department seized over $8 million in cash, luxury vehicles, and other fraud proceeds. As alleged in court documents, medical professionals made referrals for expensive and medically unnecessary cardiovascular and cancer genetic tests, as well as durable medical equipment.
The United States has filed a lawsuit against an Alabama psychiatrist for improper prescribing of Nuedexta to nursinghome residents. In return, the psychiatrist prescribed Nuedexta to nursinghome residents who did not have pseudobulbar affect.
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 nursinghome. Vaccination is mandatory for nursinghome employment in New York. Bassett stated, “Vaccination fraud is a serious crime. Update your policy as needed.
A Boston registered nurse (RN) has pled guilty to one count of tampering with a consumer product and one count of obtaining a controlled substance by fraud and deception. The RN was working in a nursinghome when she tampered with morphine that was prescribed to a resident under her care.
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. Remember: If it isn’t documented, it didn’t happen.
The South Carolina Attorney General announced that his office’s Medicaid Fraud Control Unit (SCMFCU) had arrested a 57-year-old woman on two counts of Exploitation of a Vulnerable Adult and two counts of Breach of Trust with Fraudulent Intent, value of $10,000 or more. Update as needed.
Examples of covered entities include health plans, clearinghouses, and certain health care providers including but not limited to: doctors, clinics, psychologists, dentists, chiropractors, nursinghomes, and pharmacies. There are a number of laws built to fight against Medicare/Medicaid noncompliance and fraud.
A Montana nurse who admitted to stealing opiates while working at multiple healthcare facilities was sentenced to one year and one day in prison, to be followed by one year of supervised release. The government alleged in court documents that the defendant diverted opiates in 2021 while working at multiple healthcare facilities.
An Illinois licensed practical nurse (LPN) was convicted and sentenced for failing to administer lifesaving measures to a resident in a nursinghome in 2017. Document that these trainings occurred, and file the signed documents in each employee’s education file. Update as needed.
The defendant presented the facility staff with falsified documentation indicating that she had performed neurological evaluations throughout the evening. The nurse was sentenced to six months under house arrest and may not seek reinstatement of her license or work in a care facility/home during her five-year supervision period.
MorseLife NursingHome Health System was alleged to have provided vaccines to individuals who were not eligible under this program. It was also alleged the nursinghome did not promptly test a symptomatic resident for COVID-19 and did not implement facility-wide infection control and prevention measures.
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.
While specific compliance requirements vary depending on the type of facility — from large hospitals and surgery centers to clinics and nursinghomes — having a well-structured compliance plan is essential for all medical settings. Establishing documented rules, processes, and behavioral guidelines 2. They are: 1.
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. Featured speakers: Toby R. Read a summary. COVID related investigations.
OIGs new Industry Segment-Specific Compliance Program Guidance For Nursing Facilities (Nursing Facility ICPG) for nursinghome members of the health care compliance community emphasizes the importance of staff screening and exclusion checks. Under 42 CFR Sec.
The GCPG standardized the seven Elements of a Successful Compliance Program, which differs slightly from the individual compliance guidance documents (CPGs) directed at various segments of the health care industry, such as hospitals, nursinghomes, third-party billers, and durable medical equipment suppliers.
The GCPG standardized the seven Elements of a Successful Compliance Program, which differs slightly from the individual compliance guidance documents (CPGs) directed at various segments of the health care industry, such as hospitals, nursinghomes, third-party billers, and durable medical equipment suppliers.
South Carolina Attorney General Alan Wilson announced that his office’s Medicaid Fraud Control Unit (SCMFCU) arrested a 37-year-old woman for allegedly practicing medicine as a registered nurse without a license at seven nursing and assisted living facilities in Anderson, Greenville, and Pickens counties.
About 20K nursinghome staff now have vaccine medical exemptions. More than 400 nursinghome closures projected for 2022: report. Strikes averted at four Connecticut nursinghomes but not in Windsor. State suspends Destin nursinghome license, orders it to discharge 100-plus residents.
Former CMS Chief Seema Verma Blasts NursingHome Reform Proposals. How the PE NursingHome Crackdown Could Affect the Home Health Industry. New Bill Aims to Extend Acute Hospital Care at Home Waiver. Nursinghome lobbyists request sit-down with Biden about reforms.
To Settle Telehealth Fraud Accusations State Health Dept, Hospital Association Honor Yale New Haven Hospital D.C. NATIONAL 50% of U.S. to buy property. 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
Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’
million Medicaid grant will expand mental health services in Kansas schools New staffing mandate has some Kansas nursinghomes 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.
million Medicaid grant will expand mental health services in Kansas schools New staffing mandate has some Kansas nursinghomes 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.
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.
Luke’s Children’s Hospital opens new inpatient rehab unit LC State Radiographic Science Program Ranked No. Vincent, Indianapolis Colts announce new partnership Franciscan Health launches 24/7 ambulance to help patients in rural counties Lilly to make $1.8B
CMS gives nursinghomes a longer leash on staff COVID-19 vaccination requirements. HHS releases video on documenting recognized HIPAA security practices. California physician charged with $53M mail fraud and money laundering scheme. Owner of Chicago nursinghome fined after 3 seniors died due to heat wave.
Children’s Hospital Colorado seeks congressional help on funding cuts UCHealth appoints new board members for Longs Peak, Broomfield hospitals CONNECTICUT Gov. 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.
operating loss in Q2 As RI legislators near session’s end, compromise on expensive proposals looks inevitable ‘It is wrong’: Charlesgate workers ask state to keep nursinghome open. AI ‘digital workers’ are cutting tasks that used to take a month down to 10 minutes in New Mexico. Employees love it.
But hospitals say they can’t afford to pay California hospital nurses to receive raises of up to 30% California pharmacist pleads guilty to multi-year Medicare fraud scheme Carmichael-based Eskaton pays $5.5 and Delaware Delaware struggles to investigate nursinghomes, assisted living facilities.
Wade; expected to remain big issue in 2024 races Most nursinghome residents in Arizona still haven’t gotten their COVID-19 booster COVID-19 hospitalizations are up in Arizona and around the U.S.
nursinghomes to pay $4M over claims of substandard care Mass. officials take aim at anti-abortion centers with new public awareness campaign Massachusetts, DC loosen CRNA supervision requirements Nursinghome chain with 3 Central Mass. nursinghomes to pay $4M over claims of substandard care Mass.
How tight nursinghome capacity is bottlenecking hospital operations. Over 50% of Text in EHR Notes is Duplicate Clinical Documentation. Investigators found high rates of bed sores and extended isolation among Providence nursinghome patients, leading to $310K fine. Is the doctor’s office heading for extinction?
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