News & Analysis as of

Audits Skilled Nursing Facility

NAVEX

Addressing Cybersecurity Expectations in Healthcare

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2024 is shaping up to be a very active year for regulatory and enforcement developments in the healthcare industry – developments that concern not just hospitals and nursing facilities, but many non-healthcare companies as...more

Harris Beach PLLC

HHS OIG Work Plan – January Update – Audits for Optometrists’ Services to Nursing Facility

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In its January 16, 2023, Enforcement listserv notice, HHS’s Office of Inspector General (“OIG”) recently published Work Plan Updates for January. Although six updates were published, this article only highlights the...more

Holland & Knight LLP

OIG to Audit CMS Oversight of Nursing Home Surveys by Third-Party Contractors

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The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG), a top federal watchdog tasked with overseeing Medicare, Medicaid and other HHS programs, recently announced that it will audit the...more

Ballard Spahr LLP

HHS OIG to Review CMS Citations

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Summary - The Department of Health and Human Services Office of Inspector General (HHS OIG) has announced its intention to comprehensively review nursing home citations issued by the Centers for Medicare and Medicaid...more

Polsinelli

Health Care Reimbursement and Payor Dispute Update - August 2020

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Introduction - CMS has taken extensive measures to assist providers and promote access to care in light of the Public Health Emergency (PHE) related to the COVID-19 pandemic. The efforts taken have and continue to benefit...more

ArentFox Schiff

Investigations Newsletter: Ten Individuals Charged for $1.4 Billion Health Care Billing Scheme

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Ten Individuals Charged for $1.4 Billion Health Care Billing Schemem - On June 29, an indictment was unsealed charging ten individuals with health care fraud and wire fraud for allegedly participating in a pass-through...more

Holland & Knight LLP

Comments on CMS Proposed Rule on Medicaid Fiscal Accountability Due Feb. 1, 2020

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The Centers for Medicare & Medicaid Services (CMS) on Nov. 18, 2019, published a proposed Medicaid Fiscal Accountability rule that would amend existing regulations related to 1) base and supplemental payments, 2)...more

King & Spalding

OIG Releases Audit Reports Finding High Prevalence of Nursing Home Abuse, Deficient Reporting Mechanisms

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On June 12, 2019, OIG released two audit reports, A-01-17-00513 and A-01-16-00509, as part of its efforts to improve identification, reporting, and investigation of potential abuse and neglect of Medicare beneficiaries. OIG’s...more

Bricker Graydon LLP

CMS directive orders state agencies to increase weekend surveys of skilled nursing facilities

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Staffing in long-term care facilities significantly affects the care delivered to residents. Since July 2016, nursing homes have been reporting staffing data electronically through the payroll-based journals (PBJ) system....more

McAfee & Taft

CMS Audit Practices: How false can you get?

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Caring Hearts Personal Home Care Services provided physical therapy and skilled nursing services to homebound Medicare patients. During an audit, CMS determined that Caring Hearts provided services to patients who didn’t...more

Holland & Knight LLP

HHS Issues Proposed 340B Program Omnibus Guidance: Five Things to Watch

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The 340B Drug Pricing Program (340B Program), established by Section 602 of the Veterans Health Care Act of 1992, is administered by the Health Resources and Services Administration (HRSA) of HHS. The 340B Program requires...more

Foley & Lardner LLP

Recent OIG Audits of Home Health and Hospice Surveys May Signal Increased Scrutiny on Worker Qualifications

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Recent audits by the Department of Health and Human Services Office of Inspector General (“OIG”) conclude that state survey agencies in a number of states and a leading national accrediting agency serving the home health and...more

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