In a dark week for nursing homes, courts offer beacon of hope
By
Kimberly Marselas
Mar 20, 2024
The last week has been an ugly one for nursing homes, at least if you read the consumer press. The courts offered some hope.
Might want to double check those billings
By
John O'Connor
Feb 26, 2024
To say the feds are keeping a closer eye on you is probably a bit of an understatement.
Could everything be a kickback?
By
Chris Sabis
Dec 15, 2021
The U.S. District Court for the Middle District of Tennessee recently issued a number of rulings interpreting the federal False Claims Act (FCA) and its state law counterparts relevant to long-term care...
Potential False Claims Act liability for nursing homes
By
Mysty Blagg
Jul 07, 2021
The FCA is the Department of Justice’s key tool in combating healthcare fraud and abuse The False Claims Act (FCA) provides a remedy of civil damages when a party 1) makes a false statement or engages...
The risks of ‘swapping’ for durable medical equipment
By
Lori Rubin
Japa Volchok, D.O.
Apr 14, 2021
Skilled nursing facilities are to assume the cost of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) under a bundled payment methodology for residents in Medicare Part A covered...
False Claims Act liability for poor quality of care
By
Jason R. Edgecombe and Ted Lotchin
Sep 14, 2015
Not surprisingly, different federal courts have staked out different positions on the standard for liability under a worthless services complaint.
‘Extrapolation’ demonstrates False Claims Act liability in rehab
By
Jason Edgecombe and Ted Lotchin
Aug 11, 2015
Recent FCA complaints have relied on a number of arguments to substantiate the submission of false claims for Medicare reimbursement: systematic upcoding to higher RUG levels due to corporate “pressure”...
Shamelessly invoice at your own risk
By
John O'Connor
Mar 22, 2013
Here’s the good news for providers: new analytics are making it possible to understand and bill your care in ways that would have been impossible just a few years ago. Here’s the bad news:...
In limbo with underwhelming pay proposal
By
James M. Berklan
Apr 18, 2012
First, it was the U.S. Supreme Court’s turn to leave providers in suspense. Now, it’s a group of decision-makers without robes who have operators holding their breath.