[08/02/12]
Posted on August 2, 2012 in Long-Term Care, Home Health & Hospice
Written by: Selby, Todd J.
Data collected and analyzed by the Office of Inspector General (OIG) since 2010, indicate that home health agencies (HHAs) are predisposed to commit Medicare fraud, waste and abuse. In 2010, Medicare inappropriately paid $5 million for erroneous claims submitted by HHAs. With one in four claims being suspect, the OIG established six (6) criteria... READ MORE
Tags: Audit, billing, cms, fraud, hha, Home Health, Hospice, inspector general, Medicare, oig, selby
[07/09/12]
Posted on July 9, 2012 in Health Information Technology
Published by: Hall Render
Since 2005, a group of associations known as the Long Term and Post Acute Care (LTPAC) Health Information Technology Collaborative (the Collaborative) have hosted the annual LTPAC Health IT Summit to discuss and advance health IT issues for long LTPAC providers. Following the Summit, the Collaborative publishes a Road Map that identifies the progress... READ MORE
Tags: aanac, accountable care, ahca, ahima, amda, batt, bufford, bundled payment, care coordination, cast, cms, crm, ehr, employee, facility, health it, healthcare, hms, improvement, IT, leadingage, long term care, ltc, ltpac, nasl, ncal, nf, nursing home, oig, pace, process, provider, quality, rehospitalization, road map, skill, snf, summit, technology, training
[07/09/12]
Posted on July 9, 2012 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
The Office of Inspector General (OIG) released a report this morning detailing issues found in the use of antipsychotics in nursing facilities. Utilizing a sample of records from January through June of 2007, the OIG found over 99% of records reviewed failed to meet one or more Federal requirements. READ MORE
Tags: abuse, antipsychotic, assessment, bufford, care, care plan, cms, federal, jent, long term care, medicaid, Medicare, nf, noncompliance, nursing home, oig, reduce, regulation, reimbursement, report, resident, selby, skilled nursing facility, snf
[07/06/12]
Posted on July 6, 2012 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
The Centers for Medicare & Medicaid Services (CMS) just released the 2012 Nursing Home Action Plan; a guide for CMS’ efforts to continue to improve nursing home safety and quality. The plan features 5 actionable strategies, including: enhance consumer engagement; strengthen survey processes, standards, and enforcement; promote quality improvement; create strategic approaches through partnerships; and... READ MORE
Tags: 2012 lsc, ACA, action plan, antipsychotic, assessment, bufford, cmp, cms, congress, consumer, feeding tube, hha, Home Health, idr, improvement, jent, long term care, lsc, medicaid, Medicare, nf, nursing home, nursing home compare, oig, qapi, quality, regulation, selby, skilled nursing facility, snf, survey, tags
[04/16/12]
Posted on April 16, 2012 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
The Office of the Inspector General (OIG) just released a report on the failure of nursing facilities to develop and implement adequate emergency preparedness and response programs. The “Gaps Continue to Exist in Nursing Home Emergency Preparedness and Response During Disasters: 2007-2010” report is the summation of an OIG study to assess emergency preparedness and... READ MORE
Tags: bufford, cms, disaster, emergency, jent, long term care, Medicaid/Medicare Enrollment and Regulatory Compliance, nursing home, oig, selby, training
[03/13/12]
Posted on March 13, 2012 in False Claims Act Defense
Written by: David B. Honig
February was an interesting month, with one case showing how OIG advisory opinions can be taken too far, another considering fraud under a corporate integrity agreement, and a court applying burden-shifting for the first time at the appellate level in FCA retaliation cases. Cases reviewed from February are: US ex rel. Boggs v. Bright Smile... READ MORE
Tags: advisory opinion, Aggregate Industries, Bell Constructors, Boggs, Bright Smile, caselaw, False Claims Act, fraud with particularity, Harrington, Klein, Klusmeier, law, legal, Matheny, Medco, oig, qui tam, relator, Retaliation, update, whistleblower
[02/06/12]
Posted on February 6, 2012 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
As part of their on-going video series, the Office of Inspector General (OIG) has posted a video on their self-disclosure protocols. Self-disclosure is a key element of an effective compliance program, and can possibly reduce any civil monetary penalties (CMPs) associated with a violation or instance of noncompliance. The OIG has provided many videos... READ MORE
Tags: bufford, disclosure, Home Health, Hospice, jent, Litigation and Risk Management, long term care, Medicaid/Medicare Enrollment and Regulatory Compliance, oig, selby, self, video
[01/09/12]
Posted on January 9, 2012 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
In December, the Office of the Inspector General (OIG) released an initial series of videos aimed at providers that focus on compliance issues. These videos are part of the Health Care Fraud Prevention and Enforcement Action Team (HEAT) Provider Compliance Training initiative. Health & Human Services Inspector General Daniel Levinson stated the videos are... READ MORE
Tags: bufford, compliance, exclusion, guidance, Home Health, Hospice, jent, Litigation and Risk Management, long term care, Medicaid/Medicare Enrollment and Regulatory Compliance, oig, selby, video
[12/07/11]
Posted on December 7, 2011 in Long-Term Care, Home Health & Hospice
Written by: Selby, Todd J.
On November 30, 2011, Daniel R. Levinson, Inspector General, appeared before the Special Committee on Aging, and testified regarding the Office of Inspector General’s (OIG) findings pertaining to the use of atypical antipsychotic drugs by nursing home residents. The OIG hired psychiatrists who are experts in treating elderly patients to review a sample of... READ MORE
Tags: antipsychotic, bufford, cms, drugs, elderly, FDA, hall render, inspector general, jent, Litigation and Risk Management, long term care, lvinson, Medicare, medication, nursing home, oig, resident, selby, snf
[10/14/11]
Posted on October 14, 2011 in Long-Term Care, Home Health & Hospice
Written by: Selby, Todd J.
On October 12, 2011, the U.S. Department of Justice unsealed an indictment charging Matthew Kolodesh a/k/a Matvei Kolodech, with conspiracy to defraud Medicare of more than $14 million. According to the indictment, Kolodesh’s business, Home Care Hospice, Inc. (HCH), located in Philadelphia, PA, submitted Medicare claims for approximately $14.3 million dollars for patients who... READ MORE
Tags: Audit, billing, claim review, cms, defraud, Department of Health and Human Services, Department of Justice, DHHS, false claim, hall render, Hospice, inelegible, Litigation and Risk Management, MAC, Medicare, oig, patient, payment, reimbursement, selby, terminal, terminally ill
