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. These available services should be regardless of the person’s age or physical disability.

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The Health Law Firm

AUGUST 22, 2016

Board Certified by The Florida Bar in Health Law On July 11, 2016, a federal appeals court stated that a bankruptcy judge did not have the authority to block government health officials from cutting off Medicare and Medicaid payments to a Florida nursing home that was alleged to have violated patient-care regulations.

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Hall Render

OCTOBER 28, 2024

The Centers for Medicare & Medicaid Services (“CMS”) is reinforcing regulatory expectations regarding nursing home residents’ rights to vote. On September 26, 2024, CMS issued a QSO Memo , “Compliance with Residents’ Rights requirement related to Nursing Home Residents’ Right to Vote.” 42 CFR §483.10(b)(1)

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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.

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MedTrainer

JANUARY 30, 2024

What types of healthcare facilities are required by the government to have a compliance program? In this blog, we’ll outline what types of healthcare facilities are required by the government to have a compliance program and why compliance is crucial for both healthcare organizations and the agencies that support them.

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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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Healthcare IT News - Telehealth

APRIL 13, 2023

They are asking providers to identify cancer patients and families who may qualify as ACP program enrollees, which includes households with Medicaid recipients and other federal subsidy programs, to provide them with the information they need to connect their patients with the Gilda's Club team supporting ACP enrollment.

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Healthcare IT Today

JUNE 2, 2023

Bill Charnetski, EVP, Health System Solutions & Government Affairs at PointClickCare Traditionally, long-term and post-acute care (LTPAC) facilities have not benefited from the same health IT investments or funding as other care sectors. Since the U.S. Since the U.S.

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Provider Trust

AUGUST 9, 2023

Through collaborative efforts with partners such as the Department of Justice (DOJ), Medicaid Fraud Control Units (MFCUs), and various federal, state, and local law enforcement agencies, the OIG employs a comprehensive and data-driven approach to detect, investigate, and prosecute instances of fraud.

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Healthcare IT Today

OCTOBER 19, 2023

According to Karl Ulfers, co-founder and vice president of growth at DUOS , governments offer excellent listings of resources with which care managers and clinicians can address housing, food, transportation, and other SDoH. Sema Sgaier, founder of Surgo Health, points out that different factors are important for different conditions.

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Healthcare IT Today

APRIL 19, 2024

Laura Ferrara, Chief Strategy Officer at Intus Care The focus on healthcare delivered in the comfort of one’s home has surged in recent times, particularly in light of the pandemic. Telehealth advancements, both in technology and government policy, have created greater access to care for people who might otherwise struggle to get it.

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Provider Trust

JANUARY 25, 2024

Ensuring the Financial Integrity of HHS Programs In fiscal year (FY) 2022, improper payments within healthcare programs like Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) were estimated at a staggering $131.6 With Medicaid, the challenges are equally formidable.

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Hall Render

FEBRUARY 27, 2023

Whistleblowers continue to be one of the federal government’s greatest assets in FCA cases, as whistleblowers filed 652 qui tam suits in 2022 with recovery totaling $1.9 The government initiated 296 FCA cases on its own last year without input of a relator, which is the highest volume of DOJ initiated cases since the 1986 FCA amendments.

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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.

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MedTrainer

JANUARY 15, 2025

At some point, nearly every facility must complete one, especially in long-term care where CMS data shows that nearly every active nursing home has received a deficiency in the past three years ( 28% were for actual harm or jeopardy). Plans of correction are common in Centers for Medicare and Medicaid (CMS) surveys.

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Bill of Health

SEPTEMBER 9, 2022

There are no national mandatory standards governing health care access or delivery behind bars. Some states have adopted minimum standards for prisons, jails, or both, but in Louisiana , the standards governing health care in jails have not been updated since 1980. Compare, for example, federal treatment of nursing homes with prisons.

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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”.

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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.

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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.

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Healthcare IT News - Telehealth

DECEMBER 16, 2020

As the pandemic experience varies at different times across different regions of the country, local partnerships between healthcare providers, payers, community groups and government agencies can help power a more informed response, it added. For example, nursing homes were hit hard by the virus.

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MedTrainer

NOVEMBER 28, 2023

New Jersey Healthcare Compliance Resources Let’s start with the important state government agencies you’ll need to work with: The New Jersey Department of Health (NJDOH) oversees various departments and initiatives aimed at ensuring public health, such as disease control, environmental health, emergency preparedness, and health equity.

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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?

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Pharmacy Law Blog

FEBRUARY 13, 2018

Supreme Court decision in her case holding that the government could not freeze untainted assets. Her case continued in 2017 following a 5-3 ruling by the Supreme Court holding that the government could not freeze assets belonging to her that were not tied to the alleged fraud scheme. To read more on the U.S. Let’s see.

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Compliancy Group

AUGUST 31, 2023

Let’s delve into the importance of healthcare compliance laws and regulations, their impact on providers and organizations, and the guidelines governing their implementation. Healthcare compliance laws play a vital role in safeguarding patients’ rights, preventing fraud and abuse, and maintaining the integrity of healthcare systems.

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Hall Render

NOVEMBER 18, 2022

On November 2, 2022, CMS announced revisions to the Calendar Year 2023 Payment Policies that impact Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare and Medicaid Provider Enrollment Policies (“CY 2023 PFS Final Rule”). Managing Organization.

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Hall Render

DECEMBER 11, 2024

The Proposed Rule would codify changes made by the Medicaid Services Investment and Accountability Act of 2019 (MSIAA), that added exclusion authorities related to misclassification and false information about outpatient drugs. Under 42 CFR Sec.

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Hall Render

NOVEMBER 25, 2024

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. On November 20, 2024, the Office of Inspector General (“OIG”) for the U.S.

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Hall Render

MAY 13, 2022

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. MHA discusses the significance of Medicaid’s 12-month extension for postpartum women in Michigan.

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Kaiser Health News

MARCH 3, 2022

President Joe Biden’s top Medicare official suggested Wednesday that forthcoming rules to bolster nursing home staffing won’t be issued under a mechanism, known as interim final rules, that would allow regulations to take effect more or less immediately. 30, amounting to at least 23% of all U.S.

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Healthcare Law Blog

FEBRUARY 27, 2023

On February 15, 2023, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule that would require nursing homes enrolled in Medicare and Medicaid to disclose new information about their ownership and management structures.

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C&M Health Law

MAY 11, 2022

Last week, the Centers for Medicare & Medicaid Services (CMS) released data —for the first time—reporting on mergers, acquisitions, consolidations, and changes of ownership of Medicare enrolled hospitals and nursing homes over the past six years.

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Hall Render

FEBRUARY 25, 2022

40% of Nursing Home Residents Haven’t Received COVID-19 Boosters, Analysis Finds. No COVID-19 boosters for 70% of nursing home staffs, AARP says. Contract Nurse Agencies Are Making Big Money in the Age of COVID-19. Contract Nurse Agencies Are Making Big Money in the Age of COVID-19. CALIFORNIA.

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Med-Net Compliance

NOVEMBER 1, 2022

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.

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Hall Render

APRIL 29, 2022

About 20K nursing home staff now have vaccine medical exemptions. More than 400 nursing home closures projected for 2022: report. Family nurse practitioners. Alabama Medicaid enrollment increases as pandemic requirement continues. Strikes averted at four Connecticut nursing homes but not in Windsor.

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Hall Render

MARCH 18, 2022

Former CMS Chief Seema Verma Blasts Nursing Home Reform Proposals. How the PE Nursing Home Crackdown Could Affect the Home Health Industry. New Bill Aims to Extend Acute Hospital Care at Home Waiver. Nursing home lobbyists request sit-down with Biden about reforms. CONNECTICUT.

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Hall Render

FEBRUARY 21, 2023

These proposed regulations follow through on the Biden Administration’s commitment made in the 2022 State of the Union to implement the ACA’s requirements regarding transparency in corporate ownership of nursing homes, including by collecting and publicly reporting more robust corporate ownership and operating data.

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AIHC

FEBRUARY 16, 2024

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, nursing homes, third-party billers, and durable medical equipment suppliers. The result?

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