HHS OIG’s Nursing Facility: Industry Segment-Specific Compliance Program Guidance
AGG Talks: Home Health & Hospice Podcast - Episode 10: Anti-Kickback Compliance for Hospice and Skilled Nursing Providers
Healthcare Industry Segment-Specific Compliance Program Guidances (ICPGs)
Williams Mullen's Strategies for Senior Care: The Upside of Compliance Plans for Senior Care Facilities
Williams Mullen's Strategies for Senior Care: Is Your Senior Care Facility Ready for Day One (and Two) of a Certification or Complaint Survey?
Williams Mullen's Strategies for Senior Care: Agency Investigations of Senior Care Facilities
Williams Mullen's Strategies for Senior Care: Crisis and Incident Response for Senior Care Facilities
For those seeking Medicaid coverage to pay for their care in a skilled care setting, like a nursing home, the Medicaid process can be daunting. For institutional Medicaid approval, an applicant must prove that they are...more
Traditional Medicare (Parts A and B) and Medicare Advantage (Part C, including additional vision, dental, and hearing benefits) plans aim to provide comprehensive medical benefits to American Seniors and adults with...more
Medicaid is the primary payer for 63% of nursing facility residents, propping up a large part of the industry’s funding. ...more
The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-09 (the “Opinion”) to a municipal corporation (the “Requestor” or...more
News Briefs - Congressional Extension of Telehealth Waivers Left in Limbo - Pandemic-era telehealth waivers that allowed providers to expand their virtual care footprint will end this year unless Congress takes action. The...more
In our day-to-day work representing skilled nursing facilities, we are regularly asked by our clients to assist in securing Medicaid benefits for their residents. This often entails seeking the cooperation of the resident or...more
Below is Part II of our New Jersey Statutory update. As you can see from the below, several statutes were passed imposing requirements on health insurance payers, including new requirements for prior authorization request and...more
On May 22, 2024, the Centers for Medicare and Medicaid Services (“CMS”) announced that it would be implementing updated 2024 spousal impoverishment standards that will take effect on July 1, 2024....more
Following the termination of the Public Health Emergency (“PHE”) as a result of COVID-19, and the continuous enrollment provisions put in place to ensure that Medicaid beneficiaries were able to receive Medicaid benefits...more
Medicaid is a joint federal and state program that provides health coverage to millions of Americans. Federal law requires states to comply with certain minimum requirements, but New York is considered a maximum state in that...more
The Fiscal Responsibility Act, the product of intense negotiations between the White House and House Republican leadership, suspends the debt limit and outlines government spending cuts....more
The Centers for Medicare & Medicaid Services (CMS) have released the proposed updates to the Medicare payment policies and rates for skilled nursing facilities (SNFs) for 2024. While the ruling is not final, “CMS estimates...more
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
On September 8, 2015, the U.S. Department of Health and Human Services (“HHS”) proposed new regulations implementing Section 1557 of the Patient Protection and Affordable Care Act (“ACA”). Section 1557 prohibits...more
This Week: House Ways & Means Committee Holds Markup; Makes Significant Legislative Changes to Health Care Bills... Senate Finance Committee Holds Markup on Medicare Appeals Process Bill... CMS Issues Final Rule on...more