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OIG

Medicare Part B could have saved $110 million, OIG asserts

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If the Medicare Part B program had used average Medicare Part D drug dispensing and fee rates, it would have saved the government $110 million in 2011, according to a report from the Department of Health and Human Services Office of Inspector General released Sept. 16.

Nursing homes face federal False Claims Act charges for allegedly overmedicating residents with antipsychotics, other drugs

Nursing homes face federal False Claims Act charges for allegedly overmedicating residents with antipsychotics, other drugs

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Two California nursing homes routinely overmedicated residents with antipsychotics and other drugs "for the convenience of management," according to federal charges announced Wednesday by the Office of Inspector General.

OIG: Nursing homes correctly reported 53% of abuse or neglect allegations in 2012

OIG: Nursing homes correctly reported 53% of abuse or neglect allegations in 2012

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Only about half of nursing facilities correctly reported abuse or neglect allegations in 2012, indicating that the government needs to provide more guidance and oversight, according to a new report from the Office of Inspector General.

Ask the payment expert ... about Medicare audit guidelines

Ask the payment expert ... about Medicare audit guidelines

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What guidelines should we use for a Medicare audit?

The benefits of a successful discharge plan

The benefits of a successful discharge plan

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It is critical to have a solid system for discharge planning that begins even before the resident is admitted to the facility. Individualized, resident-centered discharge planning will provide a solid system for quality transition and a crucial component of care at the preadmission assessment process.

Also in the news for June 3, 2014 . . .

Social involvement is No. 1 influence on nursing home residents' daytime sleep ... OIG casts doubt on managed care tax ... In potential Alzheimer's breakthrough, scientists use light to erase, restore rats' memories

Feds: Without more funds, we are cutting provider oversight

Feds: Without more funds, we are cutting provider oversight

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Nursing providers could feel reduced heat from federal Medicare and Medicaid oversight activities — if an agency official's testimony is to be believed as more than just budget-request bluster.

Also in the news for May 29, 2014 . . .

TX joins dual eligibles demo ... Hospitals continue to improperly code for post-acute transfers, OIG finds ... Home hospice owner gets 14-year sentence, $16M fine ... Deadly nursing home fire in South Korea

OIG revenues off $1 billion as oversight relaxes

OIG revenues off $1 billion as oversight relaxes

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Revenues from Department of Health and Human Services Office of Inspector General audits and investigations for the the first half of fiscal 2014 are expected to drop almost $1 billion from the same period last year, bolstering previous revelations that dwindling federal funding for the agency could lead to less restrictive oversight in the year to come.

Providers could be slapped with monetary penalties for slow response to document requests under OIG proposal

Providers could be slapped with monetary penalties for slow response to document requests under OIG proposal

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Long-term care providers are facing an expanded list of infractions that could trigger civil monetary penalties, including slow response to document requests. The proposed regulation from the Department of Health and Human Services Office of Inspector General was published Monday in the Federal Register.

Close the infection loop to reduce outbreak risk

Close the infection loop to reduce outbreak risk

The readmission scores of nursing homes will be posted to the Nursing Home Compare website beginning in 2017, and the VBP program will begin Oct. 1, 2018. For the first time, facilities will not just face financial penalties, they will be incentivized to reduce readmissions

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.

Cash-strapped feds to cut back Medicare oversight this year, OIG official says

Cash-strapped feds to cut back Medicare oversight this year, OIG official says

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One of nursing homes' most vigilant government watchdogs plans to dramatically curb its activities this year, a federal official has told the House Ways & Means Subcommittee on Health. The Department of Health and Human Services Office of the Inspector General anticipates reducing Medicare and Medicaid oversight activities overall by 20% in fiscal year 2014.

RACs were 'most improved' healthcare auditors for getting back money in 2013, government report states

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Medicare Recovery Audit Contractors dramatically stepped up their overpayment recoveries last year, returning nearly $487 million more to the government than they did in 2012, according to a new report from a federal watchdog agency.

Additional nursing home inspection rules are not the answer

Additional nursing home inspection rules are not the answer

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Many skilled care operators struggle to keep up with a seemingly never-ending array of survey and certification regulations. If two lawmakers get their way, providers can look forward to a large heaping of additional rules.

OIG changes its mind on referral services discounts

OIG changes its mind on referral services discounts

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Providers cannot use an online service that involves money for referrals within its network, federal regulars now say, reversing course on an advisory opinion issued three years ago. The edict came from the Department of Health and Human Services Office of Inspector General.

Nurses who don't pay taxes or student loans could trigger penalties for SNFs, expert says

Nurses who don't pay taxes or student loans could trigger penalties for SNFs, expert says

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Registered nurses who default on a student loan or fail to pay taxes could put a skilled nursing facility in the crosshairs of federal fraud investigators, a compliance expert told an audience Sunday at the American College of Health Care Administrators annual meeting in Las Vegas.

CMS is failing to ensure that terminated skilled nursing facilities and other providers are not billing Medicaid, watchdog agency says

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The Centers for Medicare & Medicaid Services needs to do a better job of ensuring that terminated Medicaid providers in a particular state, including skilled nursing facilities, don't reappear in another state, according to a new government report.

Government report: 1 in 5 Medicare patients suffers an adverse event while receiving post-acute SNF care

Government report: 1 in 5 Medicare patients suffers an adverse event while receiving post-acute SNF care

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About 22% of Medicare beneficiaries experienced an adverse event during a post-hospitalization skilled nursing facility stay in fiscal year 2011, and the majority of these events were preventable, according to a newly released government report. Post-acute provider groups said many initiatives to lower this percentage already are underway.

Adverse events and the culture of fear in long-term care

Adverse events and the culture of fear in long-term care

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The government report on adverse events in post-acute care that was released yesterday shines a light on issues of real concern. However, as long-term care stakeholders and regulators consider the implications of the report and ways to reduce the number of adverse events, I'd suggest a companion report to be read alongside it: "Is Excessive Paperwork in Care Homes Undermining Care for Older People?"

Part A claims under scrutiny

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Government investigators will issue a report on skilled nursing facilities' Medicare Part A billing practices later this year, according to the latest annual work plan from the Department of Health and Human Services Office of the Inspector General.

HHS wants civil monetary penalty rules changed

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Civil monetary penalties for providers will be revised if two proposed rules from the Department of Health and Human Services Office of the Inspector General are approved.

OIG: Hospices often out of compliance, need framing

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The Department of Health and Human Services' watchdog arm recently said hospice providers need stronger oversight measures. It also noted more than $5.8 billion in recoveries in fiscal 2013.

Who's buying your loyalty?

Who's buying your loyalty?

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While the story of former Gov. McDonnell and his wife's alleged excess may make us shake our heads, it did remind me of the slippery slope many in business or politics can fall down when it comes to gifts.

Senior living company can pay referral fees for new residents despite kickback concerns, OIG advisory opinion states

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A nonprofit senior housing and care provider can continue to pay an agency for referring new residents, despite concerns related to anti-kickback laws, according to a newly released government opinion.

OIG probes hospitalizations

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A fourth of the 3.3 million Medicare beneficiaries who lived in a nursing home in 2011 were hospitalized for at least one day. This came at a cost of $14.3 billion, according to a Nov. 18 report from the Office of the Inspector General in the Department of Health and Human Services.

I pay dead people

I pay dead people

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On Oct. 31 (an ironic coincidence?) a report from the Office of inspector General frighteningly said Medicare paid some $23 million in benefits for more than 17,000 dead people in 2011. And my husband says I waste money.

OIG calls for more frequent surveys for hospice providers

OIG calls for more frequent surveys for hospice providers

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Hospice providers could soon be facing more recertification surveys, if the Department of Health and Human Services Office of Inspector General has any say in it.

RAC program needs better oversight, Inspector General report finds

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Recovery audit contractors might be better at reviewing Medicare claims than critics allege, but the Centers for Medicare & Medicaid Services could improve RAC performance evaluations, according to a new government report.

Progress in the hospital 'observation stay' chaos

Progress in the hospital 'observation stay' chaos

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When you complain about bizarre government conditions or regulations, as columnists are wont to do, you usually have to assume you're just whispering into a stiff wind. But now comes word that no less than the Office of Inspector General of your Department of Health and Human Services is jumping on the bandwagon to change the hospital "observation stay" madness.

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