Skilled-Care Providers

News & Analysis as of

Senior Care Franchises: Important Regulatory News

Effective July 1, a home health agency that is not Medicare or Medicaid certified and does not provide skilled care is exempt from the requirement to be accredited in 400.471(2)(h), Florida Statutes. An amendment was passed...more

Be Aware of the New Fingerprint-Based Background Check Requirement for Certain Medicare Suppliers and Providers

The Center for Medicare & Medicaid Services ("CMS") recently posted on its website an article indicating that, as part of enhanced screening provisions in the Affordable Care Act, it will phase in a new fingerprint-based...more

CMS Issues Updated Guidance on Fine Imposition and the Collection Process for Nursing Homes

On April 25, 2014, the Centers for Medicare and Medicaid Services (“CMS”) issued revision 113 to the State Operations Manual (“SOM”) governing skilled nursing and nursing facility survey and enforcement processes....more

Health Law Insights Newsletter - April 2014

In This Issue: - Federal Updates - State Updates - HIPAA Updates - Excerpt from Centers for Medicare & Medicaid Services Issues Guidance for Meaningful Use Hardship Exception: The Centers...more

CMS Revises Benefit Policy Manual to Comply with Jimmo Settlement Agreement

CMS has issued revisions to the Medicare Benefit Policy Manual to comply with the settlement agreement approved in the nationwide class action lawsuit, Jimmo vs. Sebelius. In Jimmo, the plaintiff class alleged that Medicare...more

The Latest Zpic Target: Medicare Cost Reports

When Medicare was created in 1966, Medicare paid participating providers (e.g. hospitals and skilled nursing facilities) based on a portion of their costs. Medicare’s portion of costs was determined by multiplying total costs...more

Prospective and Retrospective Implications of the Jimmo Settlement Agreement for Skilled Care Providers

On January 24, 2013, the U.S District Court for the District of Vermont approved a Settlement Agreement in the so-called Medicare Improvement Standard case, Jimmo v. Sebelius. In addition to its impact on Medicare...more

ZPICs and Skilled Nursing Facilities: Medicare’s Wild Wild West

Fraud and abuse in the Medicare system undoubtedly increases healthcare costs for healthcare providers and healthcare beneficiaries. As such, healthcare providers, as a whole, can appreciate the efforts of the Department of...more

Proposed Medicare Settlement Clarifies CMS’s Position on “Skilled Maintenance Services”

On October 16, 2012, in the case of Jimmo v. Sebelius, Case No. 5:11-CV-17 (D. Vt. October 16, 2012), a class of Medicare beneficiaries and the United States Department of Health and Human Services agreed to a proposed...more

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