Jason Lundy

Jason Lundy

Polsinelli

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RAC Program to Resume Limited Reviews

On August 4, 2014, the Centers for Medicare and Medicaid Services (CMS) announced that it would allow the Recovery Audit Contractor Program (RAC) to resume a limited number of reviews in August. The program has been dormant...more

9/2/2014 - Audits CMS OMHA Recovery Audit Contractor

Proceed With Caution: Contracts Between Senior Communities And Placement Agencies May Not Violate The Anti-Kickback Statute

In This Issue: - Background of the Arrangement - The OIG’s Analysis: How the Senior Communities Reduced Their Risk - What Providers Should Know - Excerpt from Background of the Arrangement: The...more

2/6/2014 - Anti-Kickback Statute Elder Care Elder Issues Nursing Homes OIG

Streamlined RAC Appeal Processes Lead To Winning Legal And Economic Outcomes

Armed with the Recovery Audit Contract (RAC) Program, the Federal government has been very successful in recouping Medicare overpayments from health care providers in recent years. During a RAC audit, program contractors...more

1/24/2014 - Healthcare Medicare Overpayment Recovery Audit Contractor

Revisit Surveys To Slow Down Due To Budget Sequestration

As of April 5, 2013 and in response to budget sequestration, the Centers for Medicare & Medicaid Services (CMS) warns that revisit surveys for skilled nursing facilities will be delayed and approval requirements for...more

5/17/2013 - CMS Federal Budget Medicaid Sequestration SNF

CMS Ruling On Part B Rebilling After RAC Audits

On March 13, 2013, the Centers for Medicare & Medicaid Services (CMS) issued a ruling contrary to its traditional billing policy regarding payment of Part B inpatient services following denial of a Part A claim. Ruling...more

3/25/2013 - CMS Medicare Medicare Part A Medicare Part B RAC Audits

Illinois Jury Found Nursing Home Liable For $28.1 Million In Whistleblower Case Alleging Substandard Care And Resident Abuse

An Illinois district court jury in United States v. Momence Meadows Nursing Center, Inc. recently issued a verdict on February 11, 2013 imposing $28.1 million in civil penalties on the operators of a nursing home. The nursing...more

2/22/2013 - Elder Abuse False Claims Act Fraud Nursing Homes Penalties Quality of Care Standards Whistleblower Protection Policies Whistleblowers Worthless Services Claims

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