The government’s top health insurer has announced that providers could get a first look at a new type of Medicare accountable care organization this month. It has been modeled closely after a controversial...
Nursing home psychiatrist in federal custody on 52 counts of fraud, including upcoding
Oct 17, 2014
Authorities have arrested a nursing home psychiatrist and charged him with 52 counts of healthcare fraud, the U.S. Attorney for the Northern District of Texas announced Thursday.
Latest therapy-billing showdown could be ominous sign for long-term care providers
James M. Berklan
Sep 10, 2014
Don’t let anyone tell you that long-term care operators don’t know how to read between the lines. They might not have known to fear a McKnight’s Monday news item before it broke, but...
Hospitalist company with long-term care presence faces federal charges of upcoding
Jun 18, 2014
A hospitalist company that works with thousands of post-acute care facilities is officially facing federal charges that its clinicians routinely overbilled Medicare and Medicaid, authorities announced...
Federal government joins upcoding case against hospitalist company operating in LTC facilities
Dec 10, 2013
The federal government has intervened in a whistleblower lawsuit alleging that a large hospitalist company systematically overbilled government health programs, the U.S. Department of Justice announced...
Upon further review
Apr 01, 2013
Providers recoiling from recent uptick in therapy claim audits should expect even more scrutiny in the future as regulators look to increase surveillance.
‘Targeted’ EHR upcoding audits on the way
Apr 01, 2013
The Centers for Medicare & Medicaid Services will undertake targeted audits focused on upcoding in electronic health records, according to Acting CMS Administrator Marilyn Tavenner.
Government will increase EHR upcoding audits, Tavenner says
Mar 07, 2013
The Centers for Medicare & Medicaid Services will undertake targeted audits focused on upcoding in electronic health records, Acting CMS Administrator Marilyn Tavenner said Tuesday.
OIG? OMG! One lump problem
Shelly Mesure, MS, OTR/L
Jan 23, 2013
The Office of the Inspector General’s recent report about what it calls $1.5 billion in inappropriate Medicare payments to skilled nursing facilities should be yet another wake-up call to providers.
OIG slams SNFs for overbilling
Nov 13, 2012
Nursing home advocates are expected to kick into high-gear defense mode after a new federal report asserted Tuesday that providers are overcharging Medicare to the tune of $1.5 billion annually.