Court rules that SNF can’t skip part of Medicare appeals process
Apr 27, 2015
Long-term care providers may not leapfrog standard administrative appeals in Medicare reviews, as one creative Louisiana nursing home was reminded last week.
Medicare claims reviews should be more streamlined, government report states
By
Tim Mullaney
May 23, 2014
The government could improve Medicare oversight by creating a more uniform and unified post-payment review system, according to a report from federal officials.
CMS improperly measuring outcomes, report claims
By
James M. Berklan
Jan 01, 2014
So far, some providers have been put through a wringer without enough verification that it’s been worth it, according to a new Government Accountability Office report.
CMS fails to measure outcomes of the zone program integrity contractor program: government report
By
Tim Mullaney
Nov 26, 2013
The Centers for Medicare & Medicaid Services is not thoroughly assessing how well zone program integrity contractors are contributing to Medicare anti-fraud efforts, according to a new report from the...
OIG: Medicare contractors, antipsychotics in SNFs to get a closer look
By
McKnight's Staff
Oct 04, 2012
The Medicare contractors keeping close tabs on long-term care facilities will be subject to oversight too, according to a federal working plan released this week.
SNF rehab claims scrutinized more than ever, expert says
Jul 11, 2012
Nursing home administrators who can’t substantiate every minute of rehab therapy delivered in their building leave themselves open to increasingly common audits and surveys, a top MDS 3.0 expert...
Letter: Provider group accuses CMS of using Medicare audits for ‘stealth policymaking’ purposes
By
McKnight's Staff
Jun 20, 2012
A provider group is taking the Centers for Medicare & Medicaid Services to task for improperly using Medicare audits as a means of curtailing high-intensity therapy in skilled nursing facilities.
Senators: Recovery audit contractors might be doubling up tasks; campaign against fraud gears up
By
McKnight's Staff
May 03, 2012
Members of the Senate Finance Committee say they are concerned that the functions completed by independent contractors — known as recovery audit contractors (RACs) and Zone Program Integrity Contractors...