House panel hears testimony on site-neutral payments, potential for Medicaid cuts to providers

A federal agency’s  “early alert” on cases of potential abuse in nursing homes was spotlighted in its semiannual report to Congress on Thursday. The alert came from the Department of Health and Human Services’ Office of Inspector General.

Touted as a “highlight” of the OIG’s accomplishments from April through September of this year, the alert covered 134 instances of potential abuse or neglect in skilled nursing facilities. More than a quarter of them had not been reported to law enforcement, according to the OIG.

The agency has since referred all of the cases to law enforcement officials, according to the report, and suggested “immediate actions” from the Centers for Medicare & Medicaid Services to protect residents.

The office’s report to Congress also highlighted its September findings that nursing home complaints rose by 33% over four years, noting that some states “fell short” when it came to investigating serious complaints in a timely manner.

Other skilled nursing-related items featured in the OIG’s report are Genesis Healthcare’s recent $52 million False Claims Act settlement, and the 20-year federal healthcare exclusion of a Minnesota certified nursing assistant sentenced to prison for raping a resident.

In total, the OIG said it expected investigating recoveries of $4.1 billion in fiscal year 2017, as well as 881 criminal actions and 826 civil actions against individuals or entities. That’s compared to $5.66 billion in recoveries, 844 criminal actions and 709 civil actions reported in last year’s report.

Click here to read the OIG’s full semiannual report to Congress.