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.

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The Health Law Firm Blog

AUGUST 24, 2023

Board Certified by The Florida Bar in Health Law Florida's Agency for Health Care Administration (AHCA) has come under fire for failing to make Medicaid final orders accessible to the public. Indest III, J.D., On April 11, 2023, an attorney asked a Florida appeals court to revive her suit against [.]

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Health Care Law Brief

APRIL 12, 2023

On April 5, the Centers for Medicare & Medicaid Services (“CMS”) released the 2024 Medicare Advantage and Prescription Drug Benefit Programs Final Rule (“Final Rule”), which will be codified at 42 C.F.R. The SRFs include low-income subsidy, dual eligibility (meaning eligible for Medicare and Medicaid) and disability. See 42 U.S.C.

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The Health Law Firm Blog

MARCH 14, 2024

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. In addition, [.]

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The Health Law Firm Blog

DECEMBER 19, 2022

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. In addition, [.].

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Fraud Medicaid Medicaid Overpayment 52

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. Under 42 CFR Sec.

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The Health Law Firm Blog

JUNE 9, 2023

However, if you are a physician, dentist, nurse, mental health counselor, psychologist, pharmacist, physician assistant, nurse [.] Indest III, J.D.,

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The Health Law Firm Blog

JULY 26, 2023

However, if you are a physician, dentist, nurse, mental health counselor, psychologist, pharmacist, physician assistant, nurse [.] Indest III, J.D.,

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The Health Law Firm Blog

JUNE 27, 2023

However, if you are a physician, dentist, nurse, mental health counselor, psychologist, pharmacist, physician assistant, nurse [.] Indest III, J.D.,

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Medicare Medicare Nurses Overpayments 52

The Health Law Firm Blog

MAY 17, 2023

However, if you are a physician, dentist, nurse, mental health counselor, psychologist, pharmacist, physician assistant, nurse [.] Indest III, J.D.,

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Medicare Medicare Nurses Overpayments 52

YouCompli

SEPTEMBER 27, 2023

Enforcement agencies like to “follow the money,” so to speak, and they often find it in medical claims submitted to government payors such as Medicare and Medicaid.  She also claimed the hospital failed to reimburse payors for overpayment stemming from these improperly coded claims. The hospital ultimately settled and agreed to pay $3.3

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Compliance Overpayments Overpayment Medicare 52

AIHC

SEPTEMBER 5, 2023

Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations. Store-and-forward is less commonly reimbursed by Medicare and Medicaid programs. This is also called “store-and-forward telemedicine.”

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CMS.gov

NOVEMBER 16, 2018

Administrator, Centers for Medicare & Medicaid Services. One of my commitments as the Administrator of the Centers for Medicare & Medicaid Services (CMS) is to ensure we remain steadfast in our commitment to strengthen Medicare by making sure that tax dollars are spent appropriately. Fraud, waste, & abuse. Leadership. percent in 2018.

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Medicare Medicare Overpayments Overpayment 20

The Health Law Firm Blog

APRIL 19, 2024

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law In a possibly precedent-setting case, on November 9, 2022, for the first time, an appeals court in New Jersey ruled that plaintiffs in medical malpractice cases do not need an affidavit of merit to file claims against a [.]

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Malpractice Overpayments Overpayment Licensing 52

The Health Law Firm Blog

JANUARY 24, 2023

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law In a possibly precedent-setting case, on November 9, 2022, for the first time, an appeals court in New Jersey ruled that plaintiffs in medical malpractice cases do not need an affidavit of merit to file claims against a [.]

Malpractice 52

Malpractice Overpayments Overpayment Licensing 52

Hall Render

JUNE 22, 2022

On Friday, June 17, 2022, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2023 Home Health Prospective Payment System Rate Update (“PPS Rule”). Skilled Nursing. CMS states a temporary adjustment is necessary to offset this overpayment. Discipline.

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Hall Render

MAY 10, 2024

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 expansion ‘Very, very unusual.’

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Hall Render

FEBRUARY 23, 2024

CT’s Medicaid reimbursement rates lower than peer states: report Better safety training, reporting, escorts for CT home health care workers focus of new legislation D.C. Mary’s unveils new name, but mission remains unchanged UCHealth sues thousands of patients every year. What they say sets them apart.

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Nursing Homes Nurses Hospitals Medicaid 40

Hall Render

APRIL 26, 2024

New California rule aims to limit health care cost increases to 3% annually UC San Diego Health operations deal with California hospital slows to crawl Kaiser reports data breach affecting 13.4M

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Nursing Homes US Department of Health and Human Services Nurses Medicaid 40

Hall Render

JUNE 30, 2023

for physician referral scheme In Los Angeles, hospital CEO pay could be capped Kaiser Permanente ratings affirmed amid healthy financial profile Nurses vote ‘no confidence’ in California hospital administration, board Nursing facility, management company settle physician kickback allegations for $3.8M

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Hall Render

OCTOBER 7, 2022

10 states with the largest decreases to travel nurse pay. How tight nursing home capacity is bottlenecking hospital operations. Judge orders Anthem to face lawsuit over alleged Medicare overpayments. Investigators found high rates of bed sores and extended isolation among Providence nursing home patients, leading to $310K fine.

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Hall Render

APRIL 19, 2024

to Study Treatments for Vascular Abnormalities Federal Appeals Court Hears Arguments on Nation’s First Ban on Gender-affirming Care for Minors Jason Demke Hired as COO at Mercy Hospital Fort Smit Pulaski Tech Awarded $5.7M Can lawmakers do anything about it? hospital cost review board a bandage for rising costs?

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Hall Render

JANUARY 19, 2024

Did it work? Workers at another D.C.

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Hall Render

AUGUST 26, 2022

CMS bulletin presses states on Medicaid nursing home spending. CMS informational bulletin urges steps for improving health outcomes in nursing homes. CMS proposes mandatory Medicaid, CHIP quality reporting. Tie nursing home Medicaid payments to care quality, CMS tells states. Compliance with Oct. CALIFORNIA.

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Hall Render

NOVEMBER 10, 2023

Million to Settle Kickback Allegations Florida nursing home staffing changes opposed Leapfrog Group releases safety grades for Central Florida hospitals. Million to Settle Kickback Allegations Florida nursing home staffing changes opposed Leapfrog Group releases safety grades for Central Florida hospitals. See who got an A.

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Hall Render

MARCH 15, 2024

NATIONAL 3 things to expect from the pharmaceutical supply chain in 2024 Absence of AI hospital rules worries nurses American Academy of Dermatology votes to keep its diversity policies after anti-DEI proposal Are digital health partnerships replacing M&A?

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US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

MARCH 22, 2024

To qualify, facilities must close their beds Amazon’s physician acquisition strategy As Many Hospitals Continue to Face Significant Financial Challenges, MedPAC Recommends Highest Ever Medicare Payment Update Change competitors step in but breaking up may be hard to do CMS to launch new primary care ACO program Congress unveils $1.2T

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Nursing Homes US Department of Health and Human Services Nurses Hospitals 40

Hall Render

MARCH 7, 2025

expansion Mayo Clinic to invest nearly $2 billion in Valley hospital campus, hire thousands Mayo plans $1.9B expansion Mayo Clinic to invest nearly $2 billion in Valley hospital campus, hire thousands Mayo plans $1.9B expansion Mayo Clinic to invest nearly $2 billion in Valley hospital campus, hire thousands Mayo plans $1.9B

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US Department of Health and Human Services Medicaid Medicaid Nursing Homes 40

Hall Render

FEBRUARY 21, 2025

raises $95 million to boost consumer product lawsuits Denver biotech cuts $500K check when it parted ways with its CFO Denver startup raises $2.8M

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