Healthcare Compliance Blog
MARCH 16, 2022
In a March 11, 2022, release by the Northern District of Georgia’s Office of the Department of Justice, it was reported that an investigation determined a Georgia nursing home knowingly submitted claims for unreasonable, unnecessary, and unskilled services for Medicare patients. Attorney Kurt R. To avoid a “reverse false claim” (i.e.,
Modern Healthcare
AUGUST 18, 2022
CMS could consider a policy more like the one it used to correct for overpayments to nursing homes, home health leaders said.
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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.
Compliancy Group
FEBRUARY 12, 2025
Nursing facilities should: Conduct Regular Reviews and Audits: Regular reviews and audits of billing and coding practices help ensure compliance with Medicare and Medicaid program rules and prevent overpayments or fraudulent claims.
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.
Hall Render
AUGUST 4, 2023
CMS described the increase as a “parity adjustment recalibration,” noting that it had previously overestimated overpayments to nursing homes, which resulted in an unintended reduction in reimbursement in 2023. CMS issued a final rule that will increase payments to SNFs by 4%, or $1.4B, starting in 2024.
Hall Render
DECEMBER 11, 2024
OIGs new Industry Segment-Specific Compliance Program Guidance For Nursing Facilities (Nursing Facility ICPG) for nursing home members of the health care compliance community emphasizes the importance of staff screening and exclusion checks. Under 42 CFR Sec.
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