Jason Lundy

Jason Lundy

Polsinelli

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Impending Deadline: CMS Issues Proposed Rule Reform for Long Term Care Facilities – Part 3 of 4

On July 16, 2015, the Federal Register published Centers for Medicare and Medicaid Services’ (CMS) proposed rule to reform the requirements for Long Term Care Facilities participating in Medicare and Medicaid. CMS will be...more

8/3/2015 - Arbitration Arbitration Agreements CMS Compliance Ethics Healthcare Healthcare Providers HHS HIPAA Long Term Care Facilities Long-Term Care Medicaid Medicare Quality Assurance Programs

CMS Issues Proposed Rule Reform for Long Term Care Facilities - Part 1 of 4

On July 13, 2015, CMS issued a proposed rule to reform the requirements for long term care facilities participating in Medicare and Medicaid. The 400-page proposed rule recommends the biggest overhaul to nursing home...more

7/22/2015 - CMS Compliance Healthcare HHS Long Term Care Facilities Medicaid Medicare

Senate Committee Passes Bill Addressing Medicare Appeals Inefficiencies

On June 3, 2015, the Senate Finance Committee passed an original bill that aims to streamline and improve the Medicare Audit and Appeals Process. The Medicare appeals process has recently faced scrutiny from industry leaders...more

6/18/2015 - ALJ Appeals CMS Healthcare HHS Medicare OMHA RAC Audits RACs Senate Finance Committee

Changes to CMS' Five-Star Ratings System Turn Up the Heat on Nursing Homes and Increase Risks for Psychotropic Use

On Feb. 20, 2015, the Centers for Medicare & Medicaid (CMS) unveiled Version 3.0 of its Nursing Home Compare, which updates the current 5-Star Quality Rating System to reflect higher performance standards. Because of these...more

2/24/2015 - CMS Healthcare Nursing Homes Rating System

CMS Makes Limited Time Offer to Settle RAC Claims Pending Appeal

The Centers for Medicare and Medicaid Services (CMS) made an offer to settle currently pending RAC appeals for partial payment of 68 percent of the net claim amount if a hospital agrees to withdraw all of its RAC appeals. The...more

10/14/2014 - CMS Healthcare RACs

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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