One of the fallacies that we suffer under as therapists in SNFs is the mythology of the "Plateau."
A New York nursing home chain agreed Monday to pay $3.5 million to settle government allegations it failed to prevent a rehab subcontractor from overbilling Medicare for therapy.
Q: What should an administrator do to monitor therapy services in his or her facility? A: The main fact to remember is that you are responsible for what happens in your therapy department, even if you have a contract company.
As part of its pushback against the manual review process for therapy claims, the American Health Care Association has launched a clearinghouse to gather provider feedback. AHCA President Mark Parkinson described the RAC-led review process as "bifurcated, confusing and wholly inappropriate" in a four-page letter sent to Acting CMS Administrator Marilyn Tavenner last week.
Federal authorities cracked down on another regional long-term care provider recently, reaching a roughly $2.7 million settlement in a lawsuit centering on alleged false therapy billing.
Providers recoiling from recent uptick in therapy claim audits should expect even more scrutiny in the future as regulators look to increase surveillance.