Home Health Fraud “Red Flags”
Key Points: Home health care has long been recognized as vulnerable to fraud, waste, and abuse. Medicare reimburses more than…
New CMS Nursing Facility Minimum Staffing Standards
Key Points: On September 2nd, CMS proposed that nursing homes participating in Medicare and Medicaid must meet new specific nurse…
Federal Court Finds That CMS Overpayment Rule Does Not Violate Medicare Requirements
Key Points: Expect CMS to move against backlog held up by litigation. Expect an increase in DOJ investigative and enforcement…
More Than 40% of Medicare Beneficiaries in Nursing Homes May Have Developed COVID-19 in 2020
OIG report confirms COVID-19’s devastating impact on Medicare beneficiaries in nursing homes. A study of Medicare claims data by the…
GAO Calls for More Oversight of 340B Medicaid Discounts
Key points 340B compliance risk still ranks high Weak HHS oversight may be resulting in duplicate discounts Continuing conflict between…
Multi-Agency Enforcement Action Against 35 Individuals Involved in Fraudulent Genetic Testing Scheme
The Department of Justice (DOJ) recently announced a multi-agency and multi-state coordinated law enforcement action against 35 individuals involved in…
CMS Final Rule Reduces ASC Administrative Burdens
Get updated on some regulatory changes for ASCs The Centers for Medicare & Medicaid Services (CMS) issued a Final Rule…
New Medicare Beneficiary Identifier (MBI)
On August 19, 2019, CMS reissued an article regarding the New Medicare Beneficiary Identifier (MBI). The Medicare Access and CHIP Reauthorization…
CMS Moves To Ease Requirements For LTC Facilities
CMS backtracks on Compliance and Ethics Program requirements and expects the proposed rule’s changes to achieve $616 million in annual…
CRS Releases Summary Report on the SUPPORT Act Provisions Affecting Medicare
The Congressional Research Service (CRS) recently released a report on the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment…
CMS Issues Medicare Physician Fee Schedule Final Rule
The Centers for Medicare & Medicaid Services (CMS) published the final policy, payment, and quality provisions changes to the Medicare…
GAO Report on Data Analytics for Oversight and Law Enforcement
Overview Over the years, the Department of Health and Human Services Office of Inspector General and the Centers for Medicare…