News & Analysis as of

Skilled Nursing Facility Medicare Part A Medicare

Baker Donelson

Looking Back at 2024: Key Health Care Regulatory Legal Developments in Fraud and Abuse, Compliance, and Enforcement

Baker Donelson on

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

ArentFox Schiff

2024 Senior Housing Market Outlook

ArentFox Schiff on

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

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 8. News Briefs: March 2021

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

Mitchell, Williams, Selig, Gates & Woodyard,...

Understanding Medicare

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

Seyfarth Shaw LLP

Health CARES - Title III of the CARES Act Impact on Long Term Care Facilities

Seyfarth Shaw LLP on

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

Health Care Compliance Association (HCCA)

Court Says Inpatients Changed to Observation Have Right to Appeal, Orders New Process

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

Chambliss, Bahner & Stophel, P.C.

Medicare's Different Treatment of the Two Main Post-Hospital Care Options

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

Baker Donelson

DOJ Settlement Highlights False Claims Act Risk for Skilled Nursing Facilities

Baker Donelson on

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

Bricker Graydon LLP

Recent hospice settlements highlight where things can go wrong

Bricker Graydon LLP on

Two recent settlements highlight important Medicare hospice program requirements and the need to remain vigilant about compliance with Medicare program rules....more

Chambliss, Bahner & Stophel, P.C.

Medicare's Part B Premium Will Be Unchanged in 2018, But Many Will Pay More. Got That?

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

Alston & Bird

New Initiatives for the New Year: Highlights of the OIG’s 2017 Work Plan

Alston & Bird on

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

Cadwalader, Wickersham & Taft LLP

Trove of SNF Claims Data Released By CMS – Ready for Mining By Auditors and Whistleblowers

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

Polsinelli

Coming Soon to a Hospital near You: Mandatory Bundled Payments for Common Surgeries

Polsinelli on

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

Arnall Golden Gregory LLP

Expansion of Medicare Bundled Payment for Care Improvement Initiative

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

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