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Audit

Reimagining Skilled Nursing Compliance Programs: Five Key Areas of Focus from the DOJ

[06/09/20]

Posted on June 9, 2020 in Long-Term Care, Home Health & Hospice

Published by: Hall Render

Skilled nursing facilities (“SNFs”) are facing many challenges as their residents and staff encounter COVID-19 diagnosis, care and testing. During the COVID-19 pandemic, CMS and state departments of health have issued and revised interim final regulations, waivers, quality care directives, orders and multiple guidance memos. In early June 2020, the U.S. Department of Justice... READ MORE

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Infection Control and Auditing CARES Act Provider Relief Funds – OIG Unveils COVID‑19 Skilled Nursing Focus 

[05/27/20]

Posted on May 27, 2020 in COVID-19 Daily Updates, Long-Term Care, Home Health & Hospice

Published by: Hall Render

Skilled nursing facilities (“SNFs”) have two new areas of focus from the Department of Health and Human Services (“HHS”) Office of Inspector General (“OIG”) – infection control and tracking their use of CARES Act provider relief funds. OIG Work Plan Update: Infection Control Recently, the OIG updated its Work Plan, to add audit of... READ MORE

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Countdown to Phase 3 Skilled Nursing Compliance Programs – Component #6 – Auditing and Monitoring Procedures to Promote Compliance

[06/21/19]

Posted on June 21, 2019 in Long-Term Care, Home Health & Hospice

Published by: Hall Render

This is another article in a series discussing the complete overhaul of Part 483 to Title 42 of the Code of Federal Regulations the Requirements for States and Long-Term Care Facilities (“Final Regulations”) by the Centers for Medicare & Medicaid Services (“CMS”). To view other articles in this series, click here. Beginning on November 28,... READ MORE

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EEO-1 Filing Website to Open Soon – Submission Deadline Extended to May 31, 2019

[02/19/19]

Posted on February 19, 2019 in HR Insights for Health Care

Published by: Hall Render

The EEO-1 filing website will open in early March. The filing deadline has been extended to May 31, 2019. Both dates were pushed back as a result of the recent, partial federal government shutdown. Luckily for employers, the controversial pay data disclosure requirements remain on indefinite hold, as we previously reported; however, covered employers still... READ MORE

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Self-Disclosure, the Public Disclosure Bar and the FCA – Uncertainty, Circuit by Circuit

[02/11/15]

Posted on February 11, 2015 in False Claims Act Defense

Written by: David B. Honig

Written by David B. Honig and Ritu Kaur Cooper. On February 3, 2015, the Fourth Circuit Court of Appeals ruled that disclosures to the public officials responsible for managing the subject of a False Claims Act lawsuit did not qualify as “public disclosures” for the purpose of the FCA’s public disclosure bar. US ex rel. Wilson v.... READ MORE

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OFCCP Expected to Mail Next Wave of Audit Notice Letters This Week

[02/03/14]

Posted on February 3, 2014 in HR Insights for Health Care

Written by: Jonathan C. Bumgarner

The word on the street is that OFCCP will mail its next round of Corporate Scheduling Announcement Letters (“CSALs”) to unlucky federal contractors this week.  This is not a letter you want to receive, as it means your company has been targeted for an affirmative action compliance review.    READ MORE

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Inappropriate and Questionable Billing by Medicare Home Health Agencies

[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

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Hospice Owner Indicted for $14.3 Million in False Claims

[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

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