Med-Net Compliance

OCTOBER 27, 2022

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 nursing home residents in Chicago and surrounding areas.

Nursing Homes 59

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

Med-Net Compliance

JUNE 29, 2022

An Oklahoma nurse aide pleaded guilty to abusing a nursing home 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

Nursing Homes 59

Nursing Homes Nurses Fraud Medicaid 59

Healthcare Compliance Blog

JANUARY 18, 2022

On January 7, 2022, the Centers for Medicare & Medicaid Services (CMS) published a memorandum stating that nursing home staff turnover and weekend staffing will be posted on the Medicare.gov Care Compare public website. Document that these trainings occurred and file in each appropriate employee’s education file.

Nursing Homes 59

Nursing Homes Nurses Medicaid Medicaid 59

Med-Net Compliance

AUGUST 1, 2022

The Centers for Medicare & Medicaid Services launched its enhanced Nursing Home Five-Star Quality Rating System which integrates data nursing homes report on their weekend staffing rates for nurses and information on annual turnover among nurses and administrators. Ratings are updated quarterly.

Nursing Homes 59

Nursing Homes Nurses Licensing Medicaid 59

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 It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent.?Under Document that these trainings occurred and file the signed document in each employee’s education file.

Nursing Homes 59

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

Healthcare Compliance Blog

MARCH 7, 2022

After an investigation into Colorado’s care for people with disabilities who reside in nursing homes, the Department of Justice (DOJ) concluded that the state unnecessarily segregates people with physical disabilities in nursing facilities. Interview residents to ensure that all safe discharge planning needs have been met.

Nursing Homes 59

Nursing Homes Nurses ADA Medicaid 59

Hall Render

MARCH 4, 2025

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. Medical Directors in Nursing Homes 42 CFR 483.70(g)

Compliance 52

Compliance Nursing Homes Nurses Medicare 52

Hall Render

FEBRUARY 4, 2025

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 role of the medical director and how mental disorders are diagnosed. ruled out) the effects of a substance (e.g.,

Nursing Homes 52

Nursing Homes Nurses Compliance Medicaid 52

Hall Render

FEBRUARY 25, 2025

The Centers for Medicare & Medicaid Services (CMS) has given surveyors new rules and updates to allow surveyors to assess and cite violations of the regulations on resident discharge and transfer.

Nursing Homes 52

Nursing Homes Nurses Compliance Medicaid 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

Healthcare IT News - Telehealth

APRIL 24, 2020

The Alliance for Integrated Care of New York (AICNY) oversees the healthcare needs of roughly 6,200 dually eligible Medicare and Medicaid beneficiaries with intellectual and developmental disabilities (IDD). Many AICNY beneficiaries reside in group homes and use Federally Qualified Community Health Centers. THE PROBLEM. MARKETPLACE.

Telemedicine 198

Telemedicine COVID-19 Medicaid Medicaid 198

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.

Overpayments 52

Overpayments Overpayment Medicaid Medicaid 52

Healthcare Law Blog

SEPTEMBER 6, 2023

On September 1, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a long-awaited proposal to establish new federal minimum staffing standards for long-term care facilities. [1] Nurse Aide (NA) HPRD (the “2.45 Nurse Aide (NA) HPRD (the “2.45 55 RN hours per resident per day (the “.55 55 RN HPRD”); and At least 2.45

Nursing Homes 98

Nursing Homes Nurses Medicaid Medicaid 98

Hall Render

AUGUST 21, 2023

Nursing homes are critical in providing residents with care, comfort and dignity. Nursing homes need to navigate this delicate terrain with care, sensitivity and a commitment to creating a safe and respectful environment for all residents.

Nursing Homes 40

Nursing Homes Nurses Medicaid Medicaid 40

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. Accreditation.

Medicaid 97

Medicaid Medicaid Medicare Medicare 97

Hall Render

JUNE 30, 2022

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.

Nursing Homes 40

Nursing Homes Nurses Compliance Licensing 40

Healthcare Compliance Blog

MAY 18, 2022

The program is funded by the Centers for Medicare & Medicaid Services (CMS), and will establish a Center of Excellence for Building Capacity in Nursing Facilities to Care for Residents with Behavioral Health Conditions (Center for Excellence).

Nursing Homes 59

Nursing Homes Nurses Medicaid Medicaid 59

Hall Render

MAY 2, 2023

For this alert, “nursing homes” refers to skilled nursing facilities (often known as “SNFs”). In 2020, CMS revised the nursing home infection control regulations at 42 CFR § 483.80 Additionally, this information is now publicly available on CMS’s COVID Nursing Home Data Website.

Nursing Homes 40

Nursing Homes Public Health Nurses COVID-19 40

Healthcare Compliance Blog

MAY 11, 2022

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.

Fraud 59

Fraud Nursing Homes Medicaid Medicaid 59

Hall Render

JULY 5, 2023

When a patient is discharged from acute care, it is important that the acute care provider deliver accurate and appropriate patient information related to a patient’s treatment and condition in order to decrease the risk of readmission or an adverse event at the skilled nursing providers and home health agencies.

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Healthcare Compliance Blog

JANUARY 10, 2022

A South Carolina man has been arrested for financial transaction card fraud and exploitation of a vulnerable adult who was a resident of a nursing home. Document that these trainings occurred and file the signed document in each employee’s education file.

Fraud 52

Fraud Nursing Homes Nurses Medicaid 52

Hall Render

SEPTEMBER 6, 2023

On September 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule (“Proposed Rule”) that calls for minimum staffing standards in long-term care facilities (“nursing homes”). Nursing homes would need to provide residents with a minimum of 0.55 HPRD for RNs and 2.45

Nursing Homes 40

Nursing Homes Nurses Medicaid Medicaid 40

Healthcare Law Blog

DECEMBER 19, 2022

Facilities are reminded that they must keep documentation tracking (i) the educational resources offered and (ii) whether the resident or their representative accepted or refused the vaccine. viii] Who We Help – Nursing Homes | qioprogram.org. Education for Staff Regarding Up-To-Date Vaccinations and Boosters. vi] [link].

COVID-19 Vaccine 52

COVID-19 Vaccine COVID-19 Nursing Homes Nurses 52

Med-Net Compliance

JULY 26, 2022

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. In connection with the enforcement action, the department seized over $8 million in cash, luxury vehicles, and other fraud proceeds.

Fraud 59

Fraud Telemedicine Medicare Medicare 59

MedTrainer

OCTOBER 27, 2020

Keys to managing point-of-care testing complianceIn an effort to combat the spread of the virus and to help nursing homes protect the health and safety of their residents, the U.S. To be eligible, nursing homes must have a current CLIA Certificate of Waiver and meet certain epidemiological criteria.

Compliance 40

Compliance Nursing Homes COVID-19 Nurses 40

MedTrainer

OCTOBER 27, 2020

In an effort to combat the spread of the virus and to help nursing homes protect the health and safety of their residents, the U.S. To be eligible, nursing homes must have a current CLIA Certificate of Waiver and meet certain epidemiological criteria. HHS argued antigen testing is the best option available.

Compliance 40

Compliance Nursing Homes COVID-19 Nurses 40

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 Overpayment Overpayments 59

New Jersey Healthcare Blog

NOVEMBER 8, 2022

In October 2022, Centers for Medicare & Medicaid Services (CMS) made some significant changes to the Special Focus Facility (SFF) program that raise the bar for completion of the program and that increases enforcement actions for nursing homes that fail to demonstrate improvement. See 42 U.S.C. §§ 1819(f)(8), 1919(f)(1).

Nursing Homes 40

Nursing Homes Nurses Medicaid Medicaid 40

Med-Net Compliance

JULY 25, 2022

A Massachusetts nursing home failed to provide an individual’s personal representative with timely access to her son’s medical records. Document that these trainings occurred and file the signed training document in the employee’s education file.

HIPAA 59

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

MedTrainer

NOVEMBER 28, 2023

The New Jersey Hospital Association (NJHA) is a key non-profit organization that supports and advocates for nearly 400 healthcare entities in New Jersey, including hospitals and nursing homes, focusing on quality, affordable healthcare. If using a learning management system, ensure the vendor offers New Jersey -approved training.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

DECEMBER 4, 2023

The Division of Medicaid and Long-Term Care within DHHS is responsible for administering Medicaid services and overseeing long-term care programs, ensuring accessible and quality healthcare for vulnerable populations in Nebraska. If using a learning management system, ensure the vendor offers Nebraska -approved training.

Compliance 40

Compliance Licensing Nursing Homes Nurses 40

Healthcare IT News - Telehealth

MAY 6, 2020

A provider present with the patient at one location – a nursing home, community clinic, etc. Patient education material in the form of images, documents and videos is pushed to patients through the app, as well. The system can be used to conduct telehealth visits between two or more clinics.

COVID-19 216

COVID-19 FDA Hospitals Elder Care 216

Hall Render

JANUARY 17, 2025

This CMS fact sheet is the only blanket waiver that exists for skilled nursing, home health agencies, critical access hospitals, durable medical equipment and other providers. k), allowing nursing homes to admit new residents who have not received Level 1 or Level 2 Preadmission Screening.

Nursing Homes 40

Nursing Homes Nurses Public Health Medicare 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. Establishing documented rules, processes, and behavioral guidelines 2. They are: 1.

Compliance 52

Compliance Fraud Nursing Homes Governance 52

Compliancy Group

APRIL 17, 2024

Focus Areas for 2024 The OIG’s General Compliance Program Guidance (GCPG) establishes industry-specific compliance program guidance (ICPG) for 2024 that focuses on forms of fraud, waste, and abuse specific to certain types of suppliers, providers, and entities like nursing homes, clinical laboratories, and hospitals.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 52

Hall Render

DECEMBER 3, 2024

The Centers for Medicare & Medicaid Services (“CMS”) provided additional details and information related to CMS provider enrollment site visits. Providers may request to review the documents but cannot copy or retain them. Practical Takeaways Ensure your office staff are aware of the site visit verification process.

Medicare 40

Medicare Medicare Nursing Homes Medicaid 40

Hall Render

JANUARY 6, 2022

Nursing homes face possible citations, civil monetary penalties, denial of payments and—as a final measure—termination of participation from the Medicare and Medicaid programs by the Centers for Medicare & Medicaid Services (“CMS”) as they embark on complying with the new CMS COVID-19 vaccine requirements for their staff.

COVID-19 Vaccine 40

COVID-19 Vaccine COVID-19 Nurses Compliance 40