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Certifications Medicare

Husch Blackwell LLP

Do You Have a Backup? Building Redundancies Into Your Written Certification Process

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The hospice certification of terminal illness is one of the documents most scrutinized by Medicare contractors, and it is of critical importance since an invalid certification can impact Medicare payment for the patient’s...more

Weintraub Tobin

Use of Non-Physician Healthcare Practitioners Expanding in California

Weintraub Tobin on

I have been in healthcare legal practice since the mid-1990s. During a summer in law school, I worked for the California Legislative Counsel Bureau, which is the agency that serves as legal counsel to the California...more

Morgan Lewis - Health Law Scan

OIG Planning Nationwide Audit of Hospice Eligibility – What You Should Know

The HHS Office of Inspector General (OIG) recently announced its Office of Audit Services plans to conduct a nationwide review of hospice eligibility, focusing on those Medicare hospice beneficiaries who haven't had an...more

Nelson Mullins Riley & Scarborough LLP

Supreme Court Declines Request to Address False Claims Act Liability For Medically Unnecessary Services

The Supreme Court of the United States declined to take up two circuit court decisions on whether “objective falsity” is a requirement for False Claims Act (FCA) liability. The two cases, United States v. Care Alternatives...more

Bass, Berry & Sims PLC

Supreme Court Declines to Weigh in on Key Falsity Question

Bass, Berry & Sims PLC on

For several years, courts have wrestled with the question of whether subjective clinical decisions regarding the type and amount of treatment patients may need can be false for purposes of establishing False Claims Act (FCA)...more

Foley & Lardner LLP

COVID-19: Telehealth Takeaways from the CARES Act

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On March 27th, Congress passed and the President signed the Coronavirus Aid, Relief, and Economic Security Act (the CARES Act). On both the federal and state levels we have seen efforts to support social distancing in the...more

Dorsey & Whitney LLP

Sixth Circuit: Timing of Physician Certification for In-Home Care Remains Material After Escobar

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A divided panel of the U.S. Court of Appeals for the Sixth Circuit again revived an FCA suit against home-health services providers premised on the providers’ alleged improper procurement of physician medical necessity...more

K&L Gates LLP

K&L Gates Triage: Update: CMS’s Application of the Statutory Requirement that Hospitals Be “Primarily Engaged” in Providing...

K&L Gates LLP on

In September 2017, the Centers for Medicare & Medicaid Services (CMS) released a Survey and Certification memo which created interpretive guidelines for compliance with the statutory requirement that hospitals be “primarily...more

Jones Day

Sixth Circuit: Technical Physician Signature Deficiencies not "Material" to Reimbursement Claims

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The District Court for the Middle District of Tennessee held on June 22, 2017, that the timing requirements related to a physician's certification of need for home health services were not "material" to the Centers for...more

Ruder Ware

OIG Report Indicates Areas of Hospice Fraud Vulnerability and Issues a Warning to Hospice Providers

Ruder Ware on

The HHS Office of Inspector General recently released a report indicating deficiencies in hospice election statements and physician certification of patient eligibility for hospice care. Medicare hospice care provides help...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

Epstein Becker & Green

CMS Releases Key Proposals for the 2016 Qualified Health Plan Application Process

Stakeholders received insight on the Obama administration’s expected approach to the certification and oversight of qualified health plans (“QHPs”) on December 19, 2014, with the release by the Centers for Medicare & Medicaid...more

McDermott Will & Emery

CMS Extends Start Date for Stage 3 of Meaningful Use to 2017 Without Extending Timeline for When Providers Must Start Stage 2

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The Centers for Medicare & Medicaid Services recently announced a revised timeline for the implementation of Stage 3 “meaningful use” measures for the Electronic Health Records Incentive Programs, but did not extend the...more

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