By now, if you are a provider who received Provider Relief Funds, you are familiar with the related reporting requirements on the use of the Funds. But do you also have an obligation to conduct a mandatory Single Audit? ...more
The Centers for Medicare and Medicaid Services (CMS) announced that Targeted Probe and Educate (TPE) audits would resume on September 1, 2021. TPE audits had been suspended by CMS during the public health emergency. Unlike...more
The next time you step into an emergency room, you may learn the hospital can provide you with hospital-level services to treat your illness in your home. Until recently, the idea of hospitals providing services to patients...more
The year 2020 saw much less medical review auditing, including a CMS suspension of audits between March 30 and August 3 of 2020. However, with the lifting of the CMS suspension, the CMS Supplemental Medical Review Contractor...more
At long last, South Carolina has seen significant improvements in fighting COVID-19 and has made enough progress in administering COVID-19 vaccines such that Governor Henry McMaster issued an executive order on May 11, 2021...more
On April 13, 2020, the Centers for Disease Control and Prevention (CDC) and U.S. Food and Drug Administration (FDA) issued a Joint Statement on the Johnson and Johnson (J&J) COVID-19 Vaccine. The CDC and FDA are recommending...more
The Pandemic led to a rise in the use of telehealth and a recognition of its value. When the COVID-19 pandemic began, the use of telehealth to provide healthcare services and enhance access to health care grew at an...more
Over the last 25 years, I have assisted healthcare providers as a lawyer and as a compliance professional with handling routine overpayment matters, internal and external billing investigations, and fraud and abuse matters. ...more
The scope and State enforcement related to visitation in nursing home and assisted living facilities in South Carolina is controversial and evolving on a regular basis. In recent weeks the South Carolina Department of...more
The laws and policies surrounding the financial relationship between payors and healthcare providers is healthcare reimbursement law. Our attorneys and consultants have broad experience handling matters involving the full...more
On August 26, 2020, the Centers for Medicare & Medicaid Services (CMS) released extensive COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service Billing and certain provisions of the Coronavirus Aid, Relief,...more
The United States Department of Health and Human Services (HHS) recently issued a notice (the Notice) containing guidance on the timing of reporting requirements for recipients of Provider Relief Fund payments under the...more
As of July 12, there have been 142,231 confirmed COVID-19 cases and 38,518 deaths in nursing homes. For this reason, CMS recently called nursing homes “ground zero for COVID-19” and announced enhanced survey activities and...more
As the COVID-19 pandemic began this spring, the Centers for Medicare and Medicaid Services (CMS) called on all health care providers to activate infection control practices to help limit the spread of the virus....more
The U.S. Department of Health and Human Services (HHS) announced on July 14, 2020 that it is distributing rapid point-of-care diagnostic test instruments and tests to all 15,400 nursing homes throughout the country to...more
On May 15, 2020 the Elder Justice Coordinator for the Federal Trade Commission warned nursing homes and assisted living facilities not to request that Medicaid residents sign over their CARES Act stimulus checks. The FTC...more
Even in the midst of a global pandemic, some individuals and businesses have used the Coronavirus (COVID-19) crisis to take advantage of others. In response to reports of rampant fraud related to the pandemic, on March 16,...more