The pandemic doesn’t mean you can sleep on anti-kickback law compliance
Neville M. Bilimoria
Sep 22, 2021
On September 8, 2021, the Department of Justice, in connection with the Office of Inspector General, announced a settlement of $17 million against a home health agency that purchased two home health agencies...
Expert expects DOJ to ramp up nursing home enforcement efforts after pandemic
Apr 21, 2020
Providers shouldn’t assume that federal authorities will slow down enforcement efforts in the aftermath of the coronavirus pandemic. In fact, they should expect authorities to “step up” enforcement...
Playing fast and loose with Medicaid termination
May 04, 2015
There are many benefits to communicating to your cohorts in neighboring states, and not the least of it may be knowing when a provider is kicked out of Medicaid.
Ensuring nursing home quality is a top challenge for HHS in 2014, inspector general says
Dec 18, 2013
Promoting quality care in long-term care settings is one of the top management challenges facing the Department of Health and Human Services in the next year, according to a report from the agency’s...
Bill would limit Medicare claim reviews for trusted providers
Oct 18, 2013
A bill in the House of Representatives aims to create a “trusted provider” status in the Medicare program, which would potentially streamline the reimbursement and claims review processes for...
Bill calls for faster action on RAC reports, more ‘expert’ Medicaid oversight
Jun 12, 2013
The Centers for Medicare & Medicaid Services should move faster to make changes based on Medicare audits and should have more direct oversight over Medicaid, according to bipartisan legislation introduced...
Minimum Data Set information identifying providers will be shared with health plans to fight fraud, CMS...
May 30, 2013
To combat fraud and abuse, the Centers for Medicare & Medicaid Services plans to make provider-specific Minimum Data Set information available to health plans, according to a notice in Wednesday’s...
Nursing home company reaches $2.7 million settlement in therapy billing case
Mar 12, 2013
Tennessee-based nursing home operator Grace Healthcare LLC will pay the federal government more than $2.7 million, settling charges that Grace violated the False Claims Act by billing Medicare for unnecessary...
New database makes it easy to see how states are combating Medicaid fraud and abuse
Feb 01, 2013
A newly unveiled database created by the Pew Charitable Trusts provides comprehensive information about states’ strategies for combating Medicaid fraud and abuse.