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
The health care regulatory space realized significant regulatory and enforcement developments in 2024 that are influencing how providers and industry stakeholders approach various compliance measures and enforcement...more
Could 2024 bring renewed growth for the skilled nursing and senior housing market or will proposed regulatory changes and the lingering effects of COVID-19 stymie hopes for a potential rebound? With rising occupancy rates...more
On July 31, 2023, CMS issued its final rule updating the rates and Medicare payment policies under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for FY 2024 (the Final Rule). The Final Rule also includes...more
- CMS estimates its proposal will result in a decrease of $320 million in Medicare Part A payments to skilled nursing facilities. - CMS is seeking stakeholder input on the effects of direct-care staffing requirements for...more
On April 8, 2021, CMS issued proposed rules for the Fiscal Year (FY 2022) Skilled Nursing Facility (SNF) Prospective Payment System (PPS) and FY 2022 hospice payments. CMS estimates that the aggregate impact of the payment...more
Report on Medicare Compliance 30, no. 8 (March 1, 2021) - According to a CMS spokesperson, “CMS has not yet determined when Targeted Probe and Educate reviews will resume.” Meanwhile, “CMS continues to temporarily pause...more
What does Medicare cover? What are the costs of Medicare? What happens if you forget to enroll for Medicare? Medicare is the federal health insurance program for people in the United States who are over the age of 65 or...more
Congress passed and the President signed the Coronavirus Aid, Relief, and Economic Security Act (Pub. L. 116-136) (“CARES Act”) on March 27, 2020. We recently provided guidance on how the CARES Act impacts hospitals. ...more
Report on Medicare Compliance 29, no. 12 (March 30, 2020) A federal court on March 24 ordered CMS to let Medicare patients “challenge decisions by hospitals” to change their status from inpatients to observation, dating...more
Hospital patients who need additional care after being discharged from the hospital are usually sent to either an inpatient rehabilitation facility (IRF) or a skilled nursing facility (SNF). Although these facilities may look...more
The Department of Justice (DOJ) recently announced a $10 million settlement in a False Claims Act (FCA) qui tam lawsuit against Southern SNF Management, Inc. (Southern) and related skilled nursing facilities. The lawsuit...more
Two recent settlements highlight important Medicare hospice program requirements and the need to remain vigilant about compliance with Medicare program rules....more
The announcement of the 2018 Medicare premium is good news for some beneficiaries and bad news for many others. The good news is that the standard monthly Part B premium, which about 30 percent of Medicare beneficiaries pay,...more
On November 10, 2016, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) issued its 2017 Work Plan. The 2017 Work Plan outlines the areas of special concern to the OIG and...more
On September 19 and 27, 2016, the US Department of Justice announced two False Claims Act settlements that required corporate executives to make substantial monetary payments to resolve their liability. How will director and...more
Over recent years, the Federal government has trained its sights on potential billing abuses in the Medicare Part A program for Skilled Nursing Facilities (“SNFs”) in the provision of rehabilitation therapy services. The...more
Recent action by the Centers for Medicare and Medicaid Services (CMS) announces significant change in reimbursement methodology for high volume orthopedic surgical procedures in many markets nationwide. Affected stakeholders...more
On August 13, 2015, the Centers for Medicare & Medicaid Services (CMS) announced that 2,115 providers are participating in Phase 2 of the Medicare Bundled Payment for Care Improvement initiative (BPCI). These providers...more