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CMS overpayment rule may bring more whistleblower, false claims cases

CMS overpayment rule may bring more whistleblower, false claims cases

A rule released earlier this year by the Centers for Medicare & Medicaid Services targeting overpayments may lead to an increase in cases involving the regulation, according to law experts.

Audits of Medicare Advantage plans find rampant overcharging for elderly patients

Many Medicare Advantage plans overcharged the federal government for treating older beneficiaries, according to a new report from the Center for Public Integrity.

Observation stay bill hits CA governor's desk

A bill to inform California Medicare beneficiaries of their hospital observation stay status is awaiting Gov. Jerry Brown (D)'s signature.

Also in the News for Tuesday, August 30

Long-term care for LGBT seniors needs 'significant' progress ... EEOC releases final guidance on retaliation cases ... Heart failure in elderly patients to triple by 2060

Arbitration null in MA coverage disputes, state supreme court rules

Arbitration null in MA coverage disputes, state supreme court rules

Coverage disputes between Medicare Advantage plans and healthcare providers must follow a federal appeals process even if their contract calls for arbitration, the Arizona Supreme Court ruled on Thursday.

Social media use linked to less chronic illness, loneliness in seniors

Facebook, Skype and instant messaging are among technology applications that may lessen depression among seniors, a new study has found.

Seniors who rarely exercise have 50% higher risk of dementia

Older adults who don't exercise often — or don't exercise at all — have a 50% higher risk of developing dementia as they age, according to a new study in the Journals of Gerontology: Medical Sciences.

Also in the News for Monday, August 29

Team-based primary care 'significantly' improves quality study finds ... NIH to dig into social factors of healthcare ... Diabetes-linked vision loss on the rise

Providers could face Five-Star sanctions for late PBJ data

Providers could face Five-Star sanctions for late PBJ data

Nursing homes that fail to submit electronic staffing data by the first required deadline may face sanctions and could see their Five-Star rating suffer as a result, Centers for Medicare & Medicaid Services officials said Thursday.

Medicare ACOs boosted quality, savings in 2015, CMS reports

More than 100 Medicare Accountable Care Organizations qualified for shared savings payments in 2015 by meeting quality performance standards and hitting their savings threshold, according to the Centers for Medicare & Medicaid Services. The total savings for the federal government through the program is up to $1.29 billion.

SNF Medicaid coordinator arrested for stealing $13,000 from residents

The former Medicaid coordinator of a Florida skilled nursing and rehabilitation facility was arrested Wednesday after she allegedly stole more than $13,000 from three residents.

Also in the News for Friday, August 26

Staff from Virginia SNFs pitch in to help facility damaged in Louisiana floods ... Nurse protocols shown to "dramatically" reduce ER stays ... Blood test may help predict stroke risk

Medicare beneficiaries with more continuity of care at lower risk of ED visits

Medicare beneficiaries with more continuity of care at lower risk of ED visits

Older Medicare beneficiaries who have more continuity of care and consistently visit the same outpatient physician are less likely to visit an emergency room than those who receive care from several different physicians, according to a recent study.

Feds release draft interoperability standards for health IT

The push for interoperability in health information technology continued this week with the release of draft standards for the industry by federal health IT officials.

Little Sisters of the Poor cite nun shortage in giving up operations of 147-year-old nursing home

The Little Sisters of the Poor will be leaving the St. Louis nursing home they've operated for 147 years amid a shortage of nuns to staff the facility, the group announced Wednesday.

Also in the News for Thursday, August 25

Medicaid, Medicare to make up 40% of all federal spending by 2026 ... Concerns grow as for-profit companies enter PACE program ... Older adults typically happier, despite physical ailments

SNF will challenge jury's $30 million negligence verdict

SNF will challenge jury's $30 million negligence verdict

A Tennessee skilled nursing facility plans to fight back against a jury's $30 million verdict in a lawsuit alleging negligence and medical malpractice that led to a resident's death.

ICD-10 'flexibilities' to expire Oct. 1 as planned

A 12-month grace period meant to ease providers' transition to Medicare ICD-10 will officially come to a close on Oct. 1, Centers for Medicare & Medicaid Officials said last week.

CDC: Sepsis a 'race against time' for healthcare providers

Most patients with sepsis have recently been treated in a healthcare facility, and many clinicians are missing the signs, according to the Centers for Disease Control and Prevention.

Also in the News for Wednesday, August 24

University gets $1 million grant to boost nursing home quality ... Geriatric-focused ERs may help reduce hospitalizations, readmissions ... CNA who hit, shoved resident could face 4 years in prison