I recently won a case against state surveyors and I learned something new… again. The surveyors were adamant that the facility neglected a resident, and cited violations of policies, and criticized...
Retaliation, recovery and ‘quasi’ justice featured in nursing home operator’s book
Apr 16, 2021
Many long-time McKnight’s readers will remember Beechwood Restorative Care Center and its $25 million victory against the state of New York. The settlement ended a 13-year war and one of the most egregious...
Defeat the plague of improper claims
Apr 17, 2015
For recovery auditing professionals everywhere, performance-based payments are a financial best practice and the industry standard. The client wins when no upfront expenses occur and payments are made...
House leader urges HHS to end settlements meant to cut Medicare backlog
Sep 17, 2014
The Department of Health and Human Services may not have had the authority to offer providers special settlements to help clear a huge backlog of Medicare appeals, a leading Congressman said in a recent...
Congress grills top judge on appeals jam backlog
Aug 01, 2014
There is no easy fix to the staggering backlog of Medicare appeals, a government official said during a July 10 Congressional hearing.
Ask the payment expert … about continuing RAC requests
Jul 01, 2014
I thought the Recovery Audit Contractors (RACs) were on hold. Why did we still get a request for records?
McKnight’s webcast to take providers to (DAB) court
James M. Berklan
Jun 23, 2014
Providers will get a close look at and understanding of how they can challenge survey findings before an administrative law judge at a McKnight’s webinar. “So you want your day in court: Lessons...
Extra audits clog and freeze Medicare appeals process
James M. Berklan
Mar 01, 2014
Providers who want to have an administrative law judge consider a Medicare claim appeal can save their breath and memos for now.
‘Patience is wearing thin’ on Medicare appeals backlog, long-term care leader says
Feb 14, 2014
Long-term care advocates anxious about the stalled Medicare claim appeals process were not soothed after a forum with government officials Wednesday. Last month, providers learned that new appeals to administrative...
‘Irreparable harm’ to the nursing home is not enough to stay a Medicare and Medicaid termination...
Jan 27, 2014
A nursing home appealing a Medicare and Medicaid termination must meet numerous criteria to qualify for a stay of the termination, even if the facility will likely close before the appeal is decided, a...