Audit

Los Angeles County failed in investigating nursing homes, state says

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The Los Angeles County Department of Public Health did not follow standard policies pertaining to nursing home inspections, according to a review released by the state Department of Health.

Providers could be removed from Medicare and Medicaid for obstructing audits under newly proposed rule

Providers could be removed from Medicare and Medicaid for obstructing audits under newly proposed rule

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Long-term care providers who obstruct audits soon could have their Medicare and Medicaid certifications revoked, according to a newly proposed rule from a top federal watchdog. The Department of Health and Human Services Office of Inspector General has created a rule to implement this ACA provision, which was published Friday in the Federal Register.

Government presses therapy provider to repay $3 million in Medicare reimbursements

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A New Jersey-based outpatient therapy provider should pay back the government for $3.1 million in improper Medicare reimbursements identified in a recent audit, according to the Department of Health and Human Services' Office of Inspector General.

CMS to revise audit practices

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Here's the good news for providers dealing with Recovery Audit Program contractors: The federal government will make fewer additional document requests, starting this month. Now the not-so-good news: The Centers for Medicare & Medicaid Services will not slow down other components of the auditing program.

CMS widens audits, hones in on Part A claims, expert says

CMS widens audits, hones in on Part A claims, expert says

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The Centers for Medicare & Medicaid Services has increased its scrutiny of Medicare Part A filings recently and as a result, has reclaimed more funds than ever from providers, a long-term care compliance expert noted at a recent McKnight's Super Tuesday webcast.

State news

State news

Virginia — State Sen. Bill Stanley (R) has introduced a bill requiring that nursing homes, assisted living facilities and other certified nursing facilities obtain minimum levels of insurance. If SB70 becomes law, affected facilities would have to maintain liability coverage of at least $1 million, and have levels of professional liability insurance defined by the state's medical malpractice caps.

Ask the legal expert ... about due diligence when being recruited

Ask the legal expert ... about due diligence when being recruited

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I'm an administrator and am being recruited by a skilled nursing facility with past legal troubles. What should I do to satisfy myself that this facility has cleaned up its act and would be a good place to work?

Therapists can co-treat? Why yes, they can!

Therapists can co-treat? Why yes, they can!

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Have you heard? Yes, it's true. We can now provide therapy co-treatment with another discipline WITHOUT splitting our treatment time. But, not so fast ...

CMS awards 26 states with Medicaid audit contracts

CMS awards 26 states with Medicaid audit contracts

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Contracts for Medicaid recovery audit contractors (RACs) have been awarded to 26 states, government officials have announced.

CMS finds group to conduct recovery audits

The Centers for Medicare & Medicaid Services has hired a contractor to conduct recovery audit functions on Medicare Part D drug plan, according to the Bureau of National Affairs.

Medicaid audits the focus of new website

Medicaid audits the focus of new website

Providers and other stakeholders can learn more than ever about states' Medicaid Recovery Audit Contractor (RAC) programs thanks to a new website launched by the Centers for Medicare & Medicaid Services. The RAC program was created to recover improper payments and also identify underpayments. Medicaid is the No. 1 payer of nursing home services in the United States.